Individual provider Active NPI

Jordan Yvette Fuentes

  • Registered Dietitian
  • Carlsbad, NM
National Provider Identifier
1487403788
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
1410 N 8TH St Ste B
Carlsbad, NM 88220-3217
Phone
(575) 736-8520
NPI assigned
May 17, 2024
Last updated
May 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU Primary

Addresses

Primary practice location

1410 N 8TH St Ste B
Carlsbad, NM 88220-3217

Mailing address

702 N 13TH St
Artesia, NM 88210-1199
Phone (575) 748-3333

Other practice location 1

608 N 13th St.
Artesia, NM 88210
Phone (575) 748-3333

Other practice location 2

702 N 13th St
Artesia, NM 88210-1199
Phone (575) 748-3333 ext. 1707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240702001461 NM Practitioner - Registered Dietitian Or Nutrition Professional 1153865084 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Artesia General Hospital CurrentSince Jul 1, 2024 Accepting new patients
Artesia General Hospital CurrentSince Jul 1, 2024 Accepting new patients
Artesia General Hospital Past Accepting new patients

Locations

612 N 13th St
Ste G
Artesia, NM 88210
Phone (505) 736-8262

702 N 13th St
Artesia, NM 88210
Phone (505) 748-3333

1410 N 8th St
Ste B
Carlsbad, NM 88220
Phone (575) 885-2180

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/artesia-6a02e1ef

Organizations & group practices 3

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": "1715904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1487403788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 N 13TH ST",
            "city": "ARTESIA",
            "state": "NM",
            "postal_code": "882101199",
            "telephone_number": "575-748-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 N 8TH ST STE B",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203217",
            "telephone_number": "575-736-8520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "608 N 13th St.",
            "address_purpose": "LOCATION",
            "city": "Artesia",
            "state": "NM",
            "postal_code": "88210",
            "country_code": "US",
            "telephone_number": "575-748-3333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "702 N 13th St",
            "address_purpose": "LOCATION",
            "city": "Artesia",
            "state": "NM",
            "postal_code": "882101199",
            "country_code": "US",
            "telephone_number": "575-748-3333 x1707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "JORDAN",
        "middle_name": "YVETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-17",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.