Jessica Mendez, MS, RDN, CDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

008791 Issued in NY

Practice address

2545 Sheridan Dr
Tonawanda, NY 14150-9478

Phone

(716) 833-4884

NPI assigned

Nov 21, 2016

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

Other names 1

• Jessica Gwyn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1962945006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 SHERIDAN DR",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141509478",
            "telephone_number": "716-833-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 SHERIDAN DR",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141509478",
            "telephone_number": "716-833-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "JESSICA",
        "credential": "MS, RDN, CDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "008791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "GWYN",
            "credential": "MS, RDN, CDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Dietitian in Tonawanda, NY
• Providers in Tonawanda, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.