Active NPI
Jordan Elizabeth Burgess, RDN, LD
- Registered Dietitian
- Bentonville, AR
National Provider Identifier
1144071317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2288
- Practice address
- 3000 Medical Center Pkwy
Bentonville, AR 72712-3217 - Phone
- (479) 553-1000
- NPI assigned
- Mar 27, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obesity and Weight Management Nutrition Registered Dietitian | 133VN1201X | 2288 | AR | |
| Registered Dietitian | 133V00000X | 2288 | AR | Primary |
Addresses
Primary practice location
3000 Medical Center Pkwy
Bentonville, AR 72712-3217
Mailing address
3000 Medical Center Pkwy
Bentonville, AR 72712-3217
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2288 | AR | MD | Obesity and Weight Management Nutrition Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711497600000",
"number": "1144071317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 MEDICAL CENTER PKWY",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727123217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 MEDICAL CENTER PKWY",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727123217",
"telephone_number": "479-553-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGESS",
"first_name": "JORDAN",
"middle_name": "ELIZABETH",
"credential": "RDN, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-27",
"last_updated": "2024-03-27",
"certification_date": "2024-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1201X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
"state": "AR",
"license": "2288",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AR",
"license": "2288",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bentonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.