Jacqueline Judie, MS, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT86329 Issued in TX

Practice address

3700 9TH Ave N Apt 612
Texas City, TX 77590-6559

Phone

(817) 681-9130

NPI assigned

Sep 5, 2020

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• DO Life With Jackie, LTD. Co.

  • Health Maintenance Organization
  • Texas City, TX
  • NPI 1780299644
  NPD Authorized official

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

{
    "created_epoch": "1599264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599264000000",
    "number": "1447864590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 TREMONT ST",
            "address_2": "# 8051",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775505490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 9TH AVE N APT 612",
            "city": "TEXAS CITY",
            "state": "TX",
            "postal_code": "775906559",
            "telephone_number": "817-681-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDIE",
        "first_name": "JACQUELINE",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-05",
        "last_updated": "2020-09-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT86329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://pm.officeally.com/pm/PatientPortal/Default.aspx?Tab=S#/",
            "affiliation": "N",
            "endpointDescription": "Health information exchange",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3700 9th Ave N Apt 612",
            "city": "Texas City",
            "state": "TX",
            "country_code": "US",
            "postal_code": "775906559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://pm.officeally.com/pm/PatientPortal/Default.aspx?Tab=S#/",
            "affiliation": "N",
            "endpointDescription": "Office Ally",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3700 9th Ave N Apt 612",
            "city": "Texas City",
            "state": "TX",
            "country_code": "US",
            "postal_code": "775906559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jireh Counseling Center PLLC
• Jennifer Yvonne Johnson
• Sonya Yvette Johnson, LCSW
• Patrice Jonathan
• Rosalind Jones
• Jupiter Hospice LLC
• Juliet Kahiu
• Prava Karki
• Heather Zona Kaufman
• Tona J Keller, PA-C

• Registered Dietitian in Texas City, TX
• Providers in Texas City, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.

Verify at the official NPI Registry.