Active NPI
Onnie Bishop Jordan, RDN, LD
- Registered Dietitian
- St Petersburg, FL
National Provider Identifier
1972215937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND7278
- Practice address
- 145 11TH Ave NE
St Petersburg, FL 33701-1823 - Phone
- (678) 478-1696
- NPI assigned
- Dec 21, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Renal Nutrition Registered Dietitian | 133VN1005X | ND7278 | FL | |
| Registered Dietitian | 133V00000X | ND7278 | FL | Primary |
Addresses
Primary practice location
145 11TH Ave NE
St Petersburg, FL 33701-1823
Mailing address
145 11TH Ave NE
St Petersburg, FL 33701-1823
Phone (678) 478-1696
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 |
|---|---|---|---|
| ND7278 | FL | MD | Renal Nutrition Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, 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": "1671580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671580800000",
"number": "1972215937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 11TH AVE NE",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337011823",
"telephone_number": "678-478-1696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 11TH AVE NE",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337011823",
"telephone_number": "678-478-1696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "ONNIE",
"middle_name": "BISHOP",
"credential": "RDN, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-21",
"last_updated": "2022-12-21",
"certification_date": "2022-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": "FL",
"license": "ND7278",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND7278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.