Simply Dietetics, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

SIMPLY DIETETICS, LLC

Practice address

172 N Main St
Suite 1a
Sheridan, WY 82801-3921

Phone

(208) 866-2568

NPI assigned

Mar 13, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Jordan Paige McCoy, MS RD LDNPI 1508282153

Title

Owner Registered Dietitian

Phone

(208) 866-2568

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jordan McCoy, MS, RD, RDN, CDCES

  • Registered Dietitian
  • Ranchester, WY
  • NPI 1508282153

  Dietitian, Registered

  NPD (past) Authorized official

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

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489363200000",
    "number": "1124569959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 542",
            "city": "DAYTON",
            "state": "WY",
            "postal_code": "828360542",
            "telephone_number": "208-866-2568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 N MAIN ST",
            "address_2": "SUITE 1A",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828013921",
            "telephone_number": "208-866-2568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLY DIETETICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-13",
        "last_updated": "2017-03-13",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "PAIGE",
        "authorized_official_title_or_position": "OWNER REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "208-866-2568",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS RD LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mia Shifrar
• Charles Dean Shipley, LPC
• Kenneth Wayne Sickel, PA-C
• Andrew Sickler, LPN
• Sharyn Siler, LCSW
• Ammarritta Angelina Allaine Simpson
• Angelita Siojo-Allen, OTR L
• Sisterhood Sanctuary LLC
• Sisterhood Sanctuary, LLC
• Teree Lynn Sjolin

• All providers in Sheridan, WY
• Registered Dietitian in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; 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.