NPIMap

Individual provider Active NPI

Jacinda B. Roach, RD

  • Nutrition Education Nutritionist
  • Jackson, MS
National Provider Identifier
1316139181
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Education NutritionistTaxonomy code 133NN1002X
License
D1074 Issued in MS
Practice address
1860 Chadwick Dr
Suite 150
Jackson, MS 39204-3463
Phone
(601) 376-1681
Fax
(601) 376-2491
NPI assigned
Aug 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X D1074 MS Primary

Addresses

Primary practice location

1860 Chadwick Dr
Suite 150
Jackson, MS 39204-3463

Mailing address

1860 Chadwick Dr
Suite 150
Jackson, MS 39204-3463
Phone (601) 376-1681

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

Practice roles

OrganizationSpecialtyStatusNew patients
Crossgates Hma Medical Group LLC Past Accepting new patients
University Internal Medicine Assoc LLP Past Accepting new patients
Flowood River Oaks Hma Medical Group, LLC Past Accepting new patients

Organizations & group practices 3

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": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267574400000",
    "number": "1316139181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 CHADWICK DR",
            "address_2": "SUITE 150",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043463",
            "telephone_number": "601-376-1681",
            "fax_number": "601-376-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 CHADWICK DR",
            "address_2": "SUITE 150",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043463",
            "telephone_number": "601-376-1681",
            "fax_number": "601-376-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "JACINDA",
        "middle_name": "B.",
        "name_prefix": "Ms.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2010-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "MS",
            "license": "D1074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; 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.