Jordan Domenick, RD
NPI 1053988477ActiveIndividual· Dietitian, Registered· Fort Stewart, GA
Dietitian, Registered (RD) in Fort Stewart, Georgia, licensed in MO and MN, with an NPI issued in June 2021.
Overview
| NPI | 1053988477 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | RD |
| Sole proprietor | Yes |
| NPI issued | Jun 4, 2021 |
| Last updated in NPPES | Dec 28, 2023 |
| Certified by provider | Dec 28, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dietitian, Registered Primary | 133V00000X | 2022036290 | MO |
| Dietitian, Registered | 133V00000X | 4237 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other registered dietitians in Fort Stewart
- 1669911939
- 1407242175
- 1861929085
- 1700339207
- 1720412513
- 1538251095
- 1164752267
- 1932733995
- 1336066604
- 1255031761
- 1366106296
- 1841900560
All 28 registered dietitians in Fort Stewart · All registered dietitians in Georgia