Jordan Dailey Hicks, MS, RDN, LDN

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

Practice address

1 Medical Center Blvd
Winston Salem, NC 27157-2797

Phone

(336) 713-4500

NPI assigned

Oct 18, 2022

Last updated

Oct 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1245956531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5770 MIDSTREAM CIR",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129691",
            "telephone_number": "770-712-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271572797",
            "telephone_number": "336-713-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1199 Prince Ave",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306062797",
            "country_code": "US",
            "telephone_number": "706-475-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKS",
        "first_name": "JORDAN",
        "middle_name": "DAILEY",
        "credential": "MS, RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria A Hickman
• Nancy E Hickmon, OTR
• Myah Elisha Hicks-Wiggins, PA-C
• Deborah Cornwall Hicks, MED, RD, LDN
• Joel Hicks, DNP, CRNA
• Justin Paul Hicks, D.O.
• Megan Henley Hicks, M.D.
• Monique Carletta Hicks
• Brian C Hiestand, M.D.
• Hunter Lee Higdon, FNP-C

• Pediatric Nutrition Registered Dietitian in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Pediatric Nutrition Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.

Verify at the official NPI Registry.