Jordan Bontrager, RD LMNT

Primary specialty

NutritionistTaxonomy code 133N00000X

License

1470 Issued in NE

Practice address

6829 N 72ND St Ste 4500
Omaha, NE 68122-1724

Phone

(402) 717-1299

Fax

(402) 717-0770

NPI assigned

Feb 3, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Jordan Johnson Former name

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• CHI Health Clinic Specialty, LLC

  • Hospitalist Physician
  • Lincoln, NE
  • NPI 1285138065
  Medicare reassignment NPD

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1477184018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8207 NORTHWOODS DR STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685052093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6829 N 72ND ST STE 4500",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681221724",
            "telephone_number": "402-717-1299",
            "fax_number": "402-717-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONTRAGER",
        "first_name": "JORDAN",
        "credential": "RD LMNT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-03",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "IA",
            "license": "110956",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NE",
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NE",
            "license": "1470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "JOHNSON",
            "credential": "RD LMNT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bonsai Healthcare LLC (Bonsai Health)
• Amber Bonsal
• Jacqueline Bonsu
• Francine Ellen Bontao
• Jan L Bontrager
• Celena Bonwell
• Amanda Nicole Booe
• Nickelle Booe
• Destinee Booher
• Michelle Lynn Book, LIMHP

• Nutritionist in Omaha, NE
• Providers in Omaha, NE by specialty
• Nutritionist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.