Individual provider Active NPI

Jessica Byrd White, RDN, LDN

  • Registered Dietitian
  • Dothan, AL
National Provider Identifier
1578955449
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2469 Issued in AL
Practice address
1825 W Main St
Dothan, AL 36301-1319
Phone
(334) 699-8175
NPI assigned
Mar 2, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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 2469 AL Primary

Addresses

Primary practice location

1825 W Main St
Dothan, AL 36301-1319

Mailing address

1825 W Main St
Dothan, AL 36301-1319
Phone (334) 699-8175

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200404000033 AL Practitioner - Registered Dietitian Or Nutrition Professional 5395174890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jessica Byrd White, LLCGroup PAC ID 1759710254, 3 clinicians

Practice addresses (Care Compare)

1825 W Main St
Dothan, AL 36301-1319
Phone (334) 699-8175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2469ALMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jessica Byrd White LLC Dietitian, Registered CurrentSince Nov 17, 2019 Accepting new patients

Locations

3113 Wesley Way
Ste 2
Dothan, AL 36305
Phone (334) 203-4145

1825 W Main St
Dothan, AL 36301
Phone (334) 699-8175

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1578955449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 W MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011319",
            "telephone_number": "334-699-8175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 W MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011319",
            "telephone_number": "334-699-8175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JESSICA",
        "middle_name": "BYRD",
        "name_prefix": "Mrs.",
        "credential": "RDN, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-02",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AL",
            "license": "2469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.