Active NPI
Jessica Ortwein, RD, CSOWM
- Registered Dietitian
- Phoenix, AZ
National Provider Identifier
1174987143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1074991
- Practice address
- 1300 N 12TH St
Suite 612
Phoenix, AZ 85006-2848 - Phone
- (602) 521-3050
- NPI assigned
- Apr 6, 2016
- 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 | 1074991 | AZ | Primary |
Addresses
Primary practice location
1300 N 12TH St
Suite 612
Phoenix, AZ 85006-2848
Mailing address
1300 N 12TH St
Suite 612
Phoenix, AZ 85006-2848
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 |
|---|---|---|---|
| 1074991 | AZ | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666915200000",
"number": "1174987143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 N 12TH ST",
"address_2": "SUITE 612",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850062848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 N 12TH ST",
"address_2": "SUITE 612",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850062848",
"telephone_number": "602-521-3050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTWEIN",
"first_name": "JESSICA",
"credential": "RD, CSOWM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-06",
"last_updated": "2022-10-28",
"certification_date": "2022-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AZ",
"license": "1074991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.