Jessica Thornton, RDN, CSP, CLC, LDN

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

Practice address

5919 Pine Bluff Dr
Avon, IN 46123-6681

Phone

(317) 508-2066

NPI assigned

Sep 30, 2020

Last updated

Sep 30, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1760099956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5919 PINE BLUFF DR",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461236681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5919 PINE BLUFF DR",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461236681",
            "telephone_number": "317-508-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "JESSICA",
        "credential": "RDN, CSP, CLC, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-30",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IN",
            "license": "37001291A",
            "primary": false
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "133VN1401X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric Critical Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Nutrition Registered Dietitian in Avon, IN
• Providers in Avon, IN by specialty
• Pediatric Nutrition Registered Dietitian in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.