Jordan D. Mize, MS, RDN

Primary specialty

Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X

License

2015020189 Issued in MO

Practice address

100 Mercy Way
Ste 580
Joplin, MO 64804-4524

Phone

(417) 556-8555

Fax

(417) 556-8553

NPI assigned

Jun 25, 2015

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 identifiers 1

Other names 1

• Jordan D. Nichols Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1346622354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MERCY WAY",
            "address_2": "STE 580",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044524",
            "telephone_number": "417-556-8555",
            "fax_number": "417-556-8553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MERCY WAY",
            "address_2": "STE 580",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044524",
            "telephone_number": "417-556-8555",
            "fax_number": "417-556-8553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZE",
        "first_name": "JORDAN",
        "middle_name": "D.",
        "credential": "MS, RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "MO",
            "license": "2015020189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346622354",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "NICHOLS",
            "middle_name": "D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Audrey Camille Mitchell
• Becky H Mitchell, CNM
• Geoffrey Colin Mitchell, DMD
• Jennifer Ann Mitchell, D.O.
• Sally Ann Mitchell, CAA
• Moc Joplin, PLLC
• Jennifer A Mock
• Marie Moeller, CCC-SLP
• Yasser M Mokhtar, M.D.
• Annsophia Fredline Mompoint

• Metabolic Nutrition Registered Dietitian in Joplin, MO
• Providers in Joplin, MO by specialty
• Metabolic Nutrition Registered Dietitian in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; 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.