Jessica Thorman Johnson, MS, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT84348 Issued in TX

Practice address

1056 Texan Trail (Fortis Bmi)
Grapevine, TX 76051

Phone

(817) 251-0070

Fax

(817) 527-6610

NPI assigned

Jan 10, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1548733785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1056 TEXAN TRAIL (FORTIS BMI)",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "76051",
            "telephone_number": "817-251-0070",
            "fax_number": "817-527-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1056 TEXAN TRAIL (FORTIS BMI)",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "76051",
            "telephone_number": "817-251-0070",
            "fax_number": "817-527-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JESSICA",
        "middle_name": "THORMAN",
        "name_prefix": "Mrs.",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT84348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; 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.