Active NPI
Jessica Eldredge Wilcox, MNT, MS, RD, LDN
- Registered Dietitian
- Livingston, MT
National Provider Identifier
1902944093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 501
- Practice address
- 504 S 13TH St
Livingston, MT 59047-3727 - Phone
- (406) 823-6604
- Fax
- (406) 823-6602
- NPI assigned
- Feb 2, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 501 | MT | Primary |
Addresses
Primary practice location
504 S 13TH St
Livingston, MT 59047-3727
Mailing address
504 S 13TH St
Livingston, MT 59047-3727
Phone (406) 823-6604
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 298738 | Other | MT | BCBS |
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 501 | MT | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Live Nutrition Inc | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406073600000",
"number": "1902944093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 S 13TH ST",
"city": "LIVINGSTON",
"state": "MT",
"postal_code": "590473727",
"telephone_number": "406-823-6604",
"fax_number": "406-823-6602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 S 13TH ST",
"city": "LIVINGSTON",
"state": "MT",
"postal_code": "590473727",
"telephone_number": "406-823-6604",
"fax_number": "406-823-6602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILCOX",
"first_name": "JESSICA",
"middle_name": "ELDREDGE",
"credential": "MNT, MS, RD, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-02",
"last_updated": "2014-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MT",
"license": "501",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "298738",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Livingston, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.