Active NPI
Jenica Johnson, RDN, LDN
- Registered Dietitian
- Ooltewah, TN
National Provider Identifier
1851857684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2547
- Practice address
- 9018 Ooltewah Georgetown Rd Ste 122
Ooltewah, TN 37363-1515 - Phone
- (706) 503-3850
- NPI assigned
- Feb 18, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD004162 | GA | |
| Registered Dietitian | 133V00000X | 2416 | AL | |
| Registered Dietitian | 133V00000X | 2462 | SC | |
| Registered Dietitian | 133V00000X | 2547 | TN | Primary |
Addresses
Primary practice location
9018 Ooltewah Georgetown Rd Ste 122
Ooltewah, TN 37363-1515
Mailing address
9018 Ooltewah Georgetown Rd Ste 122
Ooltewah, TN 37363-1515
Phone (423) 320-2565
Other practice location 1
17 Lodgestone Dr
Ringgold, GA 30736-2169
Phone (423) 320-2565
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2462 | SC | MD | Professional Counselor |
| 2416 | AL | MD | Registered Dietitian |
| LD004162 | GA | MD | Registered Dietitian |
| 2547 | TN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749686400000",
"number": "1851857684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9018 OOLTEWAH GEORGETOWN RD STE 122",
"city": "OOLTEWAH",
"state": "TN",
"postal_code": "373631515",
"telephone_number": "423-320-2565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9018 OOLTEWAH GEORGETOWN RD STE 122",
"city": "OOLTEWAH",
"state": "TN",
"postal_code": "373631515",
"telephone_number": "706-503-3850"
}
],
"practiceLocations": [
{
"address_1": "17 Lodgestone Dr",
"address_purpose": "LOCATION",
"city": "Ringgold",
"state": "GA",
"postal_code": "307362169",
"country_code": "US",
"telephone_number": "423-320-2565",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "JENICA",
"name_prefix": "Mrs.",
"credential": "RDN, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-18",
"last_updated": "2025-06-12",
"certification_date": "2025-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD004162",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AL",
"license": "2416",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "SC",
"license": "2462",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TN",
"license": "2547",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ooltewah, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.