Jordan Wendolyn Davis, MS, RDN, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

3408 Issued in LA

Practice address

15728 Paul Vega MD Dr
Hammond, LA 70403-1434

Phone

(985) 542-5000

Fax

(985) 542-1138

NPI assigned

Aug 9, 2024

Last updated

Aug 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA, MS2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Networks

• LA PPO C-SNP

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

• Mary Bird Perkins Cancer Center

  • Clinical Medical Laboratory
  • Baton Rouge, LA
  • NPI 1295833580

  MS

  Medicare reassignment

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1104657303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 ESSEN LN STE 200",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093543",
            "telephone_number": "225-767-0847",
            "fax_number": "885-767-1335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15728 PAUL VEGA MD DR",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031434",
            "telephone_number": "985-542-5000",
            "fax_number": "985-542-1138"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1203 S Tyler St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "LA",
            "postal_code": "704332353",
            "country_code": "US",
            "telephone_number": "985-875-2234",
            "fax_number": "985-871-1447",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "133 Jefferson Davis Blvd",
            "address_purpose": "LOCATION",
            "city": "Natchez",
            "state": "MS",
            "postal_code": "391205103",
            "country_code": "US",
            "telephone_number": "601-442-1285",
            "fax_number": "601-446-9683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JORDAN",
        "middle_name": "WENDOLYN",
        "credential": "MS, RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MS",
            "license": "D-2466",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "LA",
            "license": "3408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Scott Forrest (Scotts Pharmacy)
• Annelise Davies, LAT, ATC
• Amy Davis
• Ashleigh Bergeron Davis, FNP-C
• Francine Davis
• Justin Ryan Davis
• Lakesha Davis
• Riana Leniece Davis, OTR/L
• Samantha Davis, AU.D., CCC-A
• Tamara S Davis

• Registered Dietitian in Hammond, LA
• Providers in Hammond, LA by specialty
• Registered Dietitian in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.