Jordan Neistat, NBC-HWC

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

License

A-3785068

Practice address

20444 Brentwood Ave
Bend, OR 97702-3289

Phone

(617) 595-5990

NPI assigned

Nov 1, 2023

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1698796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1811760804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20444 BRENTWOOD AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20444 BRENTWOOD AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023289",
            "telephone_number": "617-595-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEISTAT",
        "first_name": "JORDAN",
        "credential": "NBC-HWC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-01",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": "A-3785068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cody Simon Negrete, DDS
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• Carol-Ann Nelson, PT, DPT
• Grace Nelson
• Heidi Marie Nelson, L.M.T.

• Health & Wellness Coach in Bend, OR
• Providers in Bend, OR by specialty
• Health & Wellness Coach in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; 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.