Individual provider Active NPI

Jalyn Harrell

  • Dietary Manager
  • Waco, TX
National Provider Identifier
1932244498
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dietary ManagerTaxonomy code 132700000X
License
DT06441 Issued in TX
Practice address
3000 Herring Ave
Waco, TX 76708-3239
Phone
(254) 202-5631
Fax
(254) 202-5651
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dietary Manager 132700000X DT06441 TX Primary

Addresses

Primary practice location

3000 Herring Ave
Waco, TX 76708-3239

Mailing address

PO Box 20487
Waco, TX 76702-0487
Phone (254) 202-5631

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

LicenseStateTypeSpecialty
DT06441TXMDDietary Manager

Practice roles

OrganizationSpecialtyStatusNew patients
Hillcrest Baptist Medical Center 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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932244498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20487",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767020487",
            "telephone_number": "254-202-5631",
            "fax_number": "254-202-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 HERRING AVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767083239",
            "telephone_number": "254-202-5631",
            "fax_number": "254-202-5651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "JALYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "132700000X",
            "taxonomy_group": "",
            "desc": "Dietary Manager",
            "state": "TX",
            "license": "DT06441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.