Jordan Harris

Primary specialty

Sports Dietetics Nutrition Registered DietitianTaxonomy code 133VN1501X

License

86243057 Issued in NC

Practice address

1971 University Blvd Liberty Athletic Center
Lynchburg, VA 24515-0001

Phone

(336) 624-3191

NPI assigned

Mar 24, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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 and National Provider Directory roles.

• Honor Nutrition

  • Sports Dietetics Nutrition Registered Dietitian
  • Lynchburg, VA
  • NPI 1174376289

  Nutrition, Sports Dietetics

  NPD Authorized official
• Fay Nutrition

  • Registered Dietitian
  • San Francisco, CA
  • NPI 1104334465
  NPD (past)

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

{
    "created_epoch": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1386347607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7612 TIMBERLAKE RD APT 731",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245022467",
            "telephone_number": "336-624-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1971 UNIVERSITY BLVD LIBERTY ATHLETIC CENTER",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245150001",
            "telephone_number": "336-624-3191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-24",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": "NC",
            "license": "86243057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Harold, LPC
• Brianna Lee Harper, STUDENT, HEALTH CARE
• Andrea Nuckols Harris, NP
• Brooke Nicole Harris, COTA/L
• Carolyn K Harris, NP
• Joshua Michael Harris
• Kyleigh Idell Harris
• Latoya Harris
• Mackenzie Roberta Harris
• Mary Crumpler Harris, LPC

• Sports Dietetics Nutrition Registered Dietitian in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Sports Dietetics Nutrition Registered Dietitian in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; 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.