Active NPI
Jordan Leslie Badger, RD
- Registered Dietitian
- Boston, MA
National Provider Identifier
1598248486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 4500
- Practice address
- 635 Commonwealth Ave FL 6
Boston, MA 02215-1605 - Phone
- (617) 353-2721
- NPI assigned
- Sep 7, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 4500 | MA | Primary |
Addresses
Primary practice location
635 Commonwealth Ave FL 6
Boston, MA 02215-1605
Mailing address
635 Commonwealth Ave FL 6
Boston, MA 02215-1605
Phone (617) 353-2721
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4500 | Other | MA | LICENSED DIETITIAN NUTRITIONIST |
| 86065640 | Other | REGISTERED DIETITIAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4500 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536278400000",
"number": "1598248486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "635 COMMONWEALTH AVE FL 6",
"city": "BOSTON",
"state": "MA",
"postal_code": "022151605",
"telephone_number": "617-353-2721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "635 COMMONWEALTH AVE FL 6",
"city": "BOSTON",
"state": "MA",
"postal_code": "022151605",
"telephone_number": "617-353-2721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BADGER",
"first_name": "JORDAN",
"middle_name": "LESLIE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-07",
"last_updated": "2018-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "4500",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED DIETITIAN NUTRITIONIST",
"identifier": "4500",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED DIETITIAN",
"identifier": "86065640",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.