Active NPI
Jessica Evans
- Renal Nutrition Registered Dietitian
- Henderson, NV
National Provider Identifier
1740859354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Renal Nutrition Registered Dietitian
- License
- 32951-DI-4
- Practice address
- 1915 Magnolia Dr
Henderson, NV 89014-4539 - Phone
- (702) 379-2338
- NPI assigned
- Jun 18, 2021
- 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 |
|---|---|---|---|---|
| Renal Nutrition Registered Dietitian | 133VN1005X | 32951-DI-4 | Primary |
Addresses
Primary practice location
1915 Magnolia Dr
Henderson, NV 89014-4539
Mailing address
1915 Magnolia Dr
Henderson, NV 89014-4539
Phone (702) 379-2338
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623974400000",
"number": "1740859354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1915 MAGNOLIA DR",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890144539",
"telephone_number": "702-379-2338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1915 MAGNOLIA DR",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890144539",
"telephone_number": "702-379-2338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-18",
"last_updated": "2021-06-18",
"certification_date": "2021-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": null,
"license": "32951-DI-4",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.