Active NPI
Tameka Johnson, RD, CLC, CCP
- Registered Dietitian
- Jackson, MS
National Provider Identifier
1114625274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D-1329
- Practice address
- 338 Oak St
Jackson, MS 39203-1810 - Phone
- (601) 329-5751
- NPI assigned
- Feb 20, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | D-1329 | MS | Primary |
Addresses
Primary practice location
338 Oak St
Jackson, MS 39203-1810
Mailing address
338 Oak St
Jackson, MS 39203-1810
Phone (601) 329-5751
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-1329 | MS | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676851200000",
"number": "1114625274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "338 OAK ST",
"city": "JACKSON",
"state": "MS",
"postal_code": "392031810",
"telephone_number": "601-329-5751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "338 OAK ST",
"city": "JACKSON",
"state": "MS",
"postal_code": "392031810",
"telephone_number": "601-329-5751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "TAMEKA",
"credential": "RD, CLC, CCP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-20",
"last_updated": "2023-02-20",
"certification_date": "2023-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MS",
"license": "D-1329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.