Jordan Tackett, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1875 Issued in AR

Practice address

14004 Hilaro Springs Rd
Little Rock, AR 72206

Phone

(501) 860-1015

NPI assigned

Aug 24, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• BSH Health PA

  • Registered Dietitian
  • New York, NY
  • NPI 1679303465

  AL, Dietitian, Registered

  Medicare reassignment NPD
• Marjorie Nolan Cohn LLC

  • Registered Dietitian
  • New York, NY
  • NPI 1760825160

  Dietitian, Registered

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1083498463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14004 HILARO SPRINGS RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72206",
            "telephone_number": "501-860-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14004 HILARO SPRINGS RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72206",
            "telephone_number": "501-860-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "JORDAN",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AR",
            "license": "1875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrena D Tabron, B.A, M.H.P.P.
• Nangah Ngum Tabukum, MD
• Susan Tacker
• Caitlin Tackett
• Caroline Leigh Tackett
• Tad Tillemans, P.a.
• Bailey J Tadlock, PA
• Marinna Raef Tadros, MD
• Hayden Tageant, MD
• Justice Taggart

• Registered Dietitian in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Registered Dietitian in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.