Active NPI
Jordan Stilmock, RD, CLC, LMNT
- Registered Dietitian
- Blair, NE
National Provider Identifier
1629506100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86033344
- Practice address
- 810 N 22ND St
Blair, NE 68008-1128 - Phone
- (402) 426-1232
- NPI assigned
- May 30, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | ALPP-251862 | NE | |
| Registered Dietitian | 133V00000X | 86033344 | NE | Primary |
Addresses
Primary practice location
810 N 22ND St
Blair, NE 68008-1128
Mailing address
810 N 22ND St
Blair, NE 68008-1128
Phone (402) 426-1232
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86033344 | NE | MD | Registered Dietitian |
| ALPP-251862 | NE | MD | Lactation Consultant (Non-RN) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1629506100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 N 22ND ST",
"city": "BLAIR",
"state": "NE",
"postal_code": "680081128",
"telephone_number": "402-426-1232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 N 22ND ST",
"city": "BLAIR",
"state": "NE",
"postal_code": "680081128",
"telephone_number": "402-426-1232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STILMOCK",
"first_name": "JORDAN",
"credential": "RD, CLC, LMNT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-30",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": "NE",
"license": "ALPP-251862",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NE",
"license": "86033344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blair, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.