Jessica Leigh Stafford, R.D.

Primary specialty

Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X

License

934060 Issued in MO

Practice address

3412 Daybreak LN
Saint Charles, MO 63303-1942

Phone

(314) 591-7137

NPI assigned

Mar 22, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nourish, Inc.Group PAC ID 1557724937, 288 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1780950840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3412 DAYBREAK LN",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633031942",
            "telephone_number": "314-591-7137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3412 DAYBREAK LN",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633031942",
            "telephone_number": "314-591-7137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12634 Olive Blvd",
            "address_purpose": "LOCATION",
            "city": "Creve Coeur",
            "state": "MO",
            "postal_code": "631416337",
            "country_code": "US",
            "telephone_number": "314-996-0749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "JESSICA",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-22",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "MO",
            "license": "934060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12634 Olive Blvd",
            "city": "Creve Coeur",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• St. Joseph Health Center
• St. Louis First Assistants,LLC
• St. Louis JC Vamc
• St. Roberts Adult Day Program
• Stacey Hensler Stone
• Laquesha Stanciel
• State of Missouri
• State of Missouri
• Brenden A Stealey, MD
• Sandra Stegman, LPTA

• Metabolic Nutrition Registered Dietitian in Saint Charles, MO
• Providers in Saint Charles, MO by specialty
• Metabolic Nutrition Registered Dietitian in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.