Jennifer Boynton, MS, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT82913 Issued in TX

Practice address

712 Hayter 13010 Sfa Sta
Nacogdoches, TX 75962-0001

Phone

(936) 468-3506

Fax

(936) 468-4580

NPI assigned

Oct 30, 2013

Last updated

Oct 30, 2013By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Stephen F. Austin State University

  dba Stephen F. Austin State University Sports Medicine

  • Student Health Clinic/Center
  • Nacogdoches, TX
  • NPI 1477807121
  NPD (past)

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

{
    "created_epoch": "1383091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1790113736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 HAYTER 13010 SFA STA",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759620001",
            "telephone_number": "936-468-3506",
            "fax_number": "936-468-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 HAYTER 13010 SFA STA",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759620001",
            "telephone_number": "936-468-3506",
            "fax_number": "936-468-4580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYNTON",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-30",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT82913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vasudeva M Bommanna, MD
• Shauna Lynn Bond, COTA
• Bonita Creek Emergency Services PLLC
• Douglas Bowlin, PTA
• Misty Adams Bowlin
• Boys Ranch of Nacogdoches, Inc (Nacogdoches Boys Ranch)
• Braces R US PC
• David Glynn Bradley
• George Bradley, LPC
• Brett Shirley DDS MD PLLC (Piney Woods Oral and Maxillofacial Surgery)

• Registered Dietitian in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; 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.