Individual provider Active NPI

Jennifer Leigh Witherspoon, MS, RD, CSO, LD

  • Registered Dietitian
  • Oklahoma City, OK
National Provider Identifier
1346473816
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1435 Issued in OK
Practice address
800 NE 10TH St Ste 6049
Oklahoma City, OK 73104-5418
Phone
(405) 271-8001
NPI assigned
Aug 31, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Nutrition Registered Dietitian 133VN1301X 1435 OK
Registered Dietitian 133V00000X 1435 OK Primary

Addresses

Primary practice location

800 NE 10TH St Ste 6049
Oklahoma City, OK 73104-5418

Mailing address

800 NE 10TH St Ste 6049
Oklahoma City, OK 73104-5418
Phone (405) 271-8001

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1435OKMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Aug 1, 2017 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Aug 1, 2017 Accepting new patients

Locations

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

Organizations & group practices 4

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": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1346473816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 NE 10TH ST STE 6049",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045418",
            "telephone_number": "405-271-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 NE 10TH ST STE 6049",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045418",
            "telephone_number": "405-271-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERSPOON",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "credential": "MS, RD, CSO, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1301X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Oncology",
            "state": "OK",
            "license": "1435",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "1435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.