Active NPI
Jennifer Damour
- Registered Dietitian
- Joplin, MO
National Provider Identifier
1629465547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2002021884
- Practice address
- 1905 W 32ND St Ste 303
Joplin, MO 64804-1512 - Phone
- (417) 782-4100
- Fax
- (417) 782-4116
- NPI assigned
- Apr 17, 2015
- Last updated
- Apr 17, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | 2002021884 | MO | Primary |
Addresses
Primary practice location
1905 W 32ND St Ste 303
Joplin, MO 64804-1512
Mailing address
1905 W 32ND St Ste 303
Joplin, MO 64804-1512
Phone (417) 782-4100
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 |
|---|---|---|---|
| 2002021884 | MO | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Damour Family Medicine | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Joplin, MO
- NPI 1437487790
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429228800000",
"number": "1629465547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1905 W 32ND ST STE 303",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648041512",
"telephone_number": "417-782-4100",
"fax_number": "417-782-4116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1905 W 32ND ST STE 303",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648041512",
"telephone_number": "417-782-4100",
"fax_number": "417-782-4116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAMOUR",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-17",
"last_updated": "2015-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MO",
"license": "2002021884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joplin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.