Krista M Jordan, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

130 Issued in AK

Practice address

5955 Zeamer Avenue
3Rd MDG/Wic Office
Elmendorf Afb, AK 99506

Phone

(907) 580-3205

NPI assigned

Aug 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Krista M Kirschbaum Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187222400000",
    "number": "1083806640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVENUE",
            "address_2": "3RD MDG/WIC OFFICE",
            "city": "ELMENDORF AFB",
            "state": "AK",
            "postal_code": "99506",
            "telephone_number": "907-580-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVENUE",
            "address_2": "3RD MDG/WIC OFFICE",
            "city": "ELMENDORF AFB",
            "state": "AK",
            "postal_code": "99506",
            "telephone_number": "907-580-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "KRISTA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-16",
        "last_updated": "2007-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AK",
            "license": "130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTA",
            "last_name": "KIRSCHBAUM",
            "middle_name": "M",
            "prefix": "MISS",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jane Elizabeth Heetderks-Cox, RD
• Tommi Alana Heim
• Angie Hingst, LCSW
• Brennan Kaine Jacobs, PHARMD
• Matthew James Joo, D.O.
• Kimpreet Kaur
• Matthew James Kessler, PH.D.
• Ronald Michael Kichura, O.D.
• Jeanette Katharine Klamfoth, D.O.
• Winifred Gail Koehler, WHCNP

• Registered Dietitian in Elmendorf Afb, AK
• Providers in Elmendorf Afb, AK by specialty
• Registered Dietitian in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.