Active NPI
Joanna Leigh Cupp, MS, RD, LDN
- Registered Dietitian
- State University, AR
National Provider Identifier
1356612436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.005327
- Practice address
- 106 North Caraway
Eugene Smith Room 410
State University, AR 72467-7246 - Phone
- (870) 680-8295
- NPI assigned
- Jan 20, 2012
- Last updated
- Sep 9, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164.005327 | IL | Primary |
Addresses
Primary practice location
106 North Caraway
Eugene Smith Room 410
State University, AR 72467-7246
Mailing address
106 North Caraway
Eugene Smith Room 410
State University, AR 72467
Phone (870) 680-8295
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
| License | State | Type | Specialty |
|---|---|---|---|
| 164.005327 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599609600000",
"number": "1356612436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 NORTH CARAWAY",
"address_2": "EUGENE SMITH ROOM 410",
"city": "STATE UNIVERSITY",
"state": "AR",
"postal_code": "72467",
"telephone_number": "870-680-8295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 NORTH CARAWAY",
"address_2": "EUGENE SMITH ROOM 410",
"city": "STATE UNIVERSITY",
"state": "AR",
"postal_code": "724677246",
"telephone_number": "870-680-8295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUPP",
"first_name": "JOANNA",
"middle_name": "LEIGH",
"name_prefix": "Mrs.",
"credential": "MS, RD, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-20",
"last_updated": "2020-09-09",
"certification_date": "2020-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.005327",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in State University, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.