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

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 and National Provider Directory roles.

• 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": "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"
        },
        {
            "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"
        }
    ],
    "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
• 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.