Active NPI
Jessica McDonald
- Registered Dietitian
- Saint Charles, MO
National Provider Identifier
1992423628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2022018964
- Practice address
- 300 1St Capitol Dr
Saint Charles, MO 63301-2844 - Phone
- (636) 669-2271
- NPI assigned
- Aug 18, 2022
- 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 | 2022018964 | MO | Primary |
Addresses
Primary practice location
300 1St Capitol Dr
Saint Charles, MO 63301-2844
Mailing address
71 Austin Oaks Dr
Moscow Mills, MO 63362-0401
Phone (636) 290-2993
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 |
|---|---|---|---|
| 2022018964 | MO | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660780800000",
"number": "1992423628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "71 AUSTIN OAKS DR",
"city": "MOSCOW MILLS",
"state": "MO",
"postal_code": "633620401",
"telephone_number": "636-290-2993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 1ST CAPITOL DR",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633012844",
"telephone_number": "636-669-2271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-18",
"last_updated": "2022-08-18",
"certification_date": "2022-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MO",
"license": "2022018964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Charles, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.