Active NPI
Jaclyn West, REGISTERED DIETITION
- Registered Dietitian
- Paducah, KY
National Provider Identifier
1154098879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2016
- Practice address
- 3360 Wayne Sullivan Dr
Paducah, KY 42003 - Phone
- (270) 443-9474
- Fax
- (270) 443-9477
- NPI assigned
- Aug 30, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2016 | KY | Primary |
Addresses
Primary practice location
3360 Wayne Sullivan Dr
Paducah, KY 42003
Mailing address
PO Box 497
Augusta, AR 72006-0497
Phone (870) 347-2534
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Current | Accepting new patients |
Locations
515 S Flower St
#1015
Los Angeles, CA 90071
3499 Blazer Pkwy
Ste 330
Lexington, KY 40509
Phone (410) 885-4727
500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000
3724 Jefferson St
Ste 104
Austin, TX 78731
Phone (512) 399-9039
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": "1630281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630281600000",
"number": "1154098879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 497",
"city": "AUGUSTA",
"state": "AR",
"postal_code": "720060497",
"telephone_number": "870-347-2534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3360 WAYNE SULLIVAN DR",
"city": "PADUCAH",
"state": "KY",
"postal_code": "42003",
"telephone_number": "270-443-9474",
"fax_number": "270-443-9477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEST",
"first_name": "JACLYN",
"name_prefix": "Ms.",
"credential": "REGISTERED DIETITION",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-30",
"last_updated": "2021-08-30",
"certification_date": "2021-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KY",
"license": "2016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paducah, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.