Jennifer Nicole Mahoney, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2015026976 Issued in MO

Practice address

10407 Clayton Rd
Frontenac, MO 63131-2909

Phone

(314) 432-6103

Fax

(314) 692-0448

NPI assigned

Oct 29, 2018

Last updated

Oct 29, 2018By 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

Other names 1

• Jennifer Nicole Livaudais Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Flourish. Nutrition Therapy

  • Community Health Clinic/Center
  • Saint Louis, MO
  • NPI 1184197816
  NPD Authorized official
• Nutriformance

  • Community Health Clinic/Center
  • Frontenac, MO
  • NPI 1265909154
  NPD (past)

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1306313200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6222 POTOMAC ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631392011",
            "telephone_number": "314-605-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10407 CLAYTON RD",
            "city": "FRONTENAC",
            "state": "MO",
            "postal_code": "631312909",
            "telephone_number": "314-432-6103",
            "fax_number": "314-692-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-29",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2015026976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "LIVAUDAIS",
            "middle_name": "NICOLE",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Kraemer, DPT
• Evan Kuhl, PT, DPT, XPS, USAW-1
• Kunj Govind Patel MD LLC, a Series LLC (Center for Regenerative and Interventional Spine and Sports Pain)
• Life Clinic of Mo DC PC
• Paige M Luth, DC
• Lauren McGaughey, PA-C
• Melanie Melissa Miranda, WHNP-BC
• Nra-St. Louis (Home Therapy Center), Missouri, LLC (Frontenac Home Dialysis Center)
• Nutriformance
• Samantha O'Daniel

• Registered Dietitian in Frontenac, MO
• Providers in Frontenac, MO by specialty
• Registered Dietitian in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; 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.