Individual provider

Jordan Domenick, RD

Registered Dietitian

Jordan Domenick, RD is a Registered Dietitian in Fort Stewart, GA, registered under NPI 1053988477. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.

Getting there

The practice address on file is 1061 HARMON AVE, Fort Stewart, GA 31314. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

1061 HARMON AVE, Fort Stewart, GA 31314 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
2022036290 MO Registered Dietitian primary
4237 MN Registered Dietitian

Licences are recorded in 2 states: MO, MN. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)

This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.

Licensed in 2 states

This provider holds licences in 2 states: Minnesota and Missouri. Multi-state licensure often means the provider works near a state border, covers more than one office, or delivers care by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

MN Minnesota
Licence
4237
Specialty
Registered Dietitian
Verify with the MN board →
MO Missouri
Licence
2022036290
Specialty
Registered Dietitian
Verify with the MO board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Dietitian, Registered covers

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation. NUCC Health Care Provider Taxonomy, code 133V00000X
Dietary & Nutritional Service Providers Dietitian, Registered

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
133V00000X Registered Dietitian 2022036290 MO primary
133V00000X Registered Dietitian 4237 MN

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1053988477 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateJun 4, 2021
Last updatedDec 28, 2023
StatusActive
Sole proprietorYes
CredentialRD
Practice address 1061 HARMON AVE
Fort Stewart, GA 31314
(912) 435-6633
This record was updated on Dec 28, 2023, which is recent enough that the contact details are likely still accurate.

Number check

1053988477 passes the NPI check digit test The final digit 7 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 0 5 3 9 8 8 4 7
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 0 1 3 9 8 7 4 5

Sum = 63 · next multiple of 10 = 70 · check digit = 7 · actual last digit = 7

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1053988477?
NPI 1053988477 is the National Provider Identifier assigned to Jordan Domenick, RD in Fort Stewart, GA. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Registered Dietitian cover?
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's…
How do I contact Jordan Domenick, RD?
The phone number on file with NPPES is (912) 435-6633, last updated Dec 28, 2023. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Is NPI 1053988477 a valid number?
Yes. 1053988477 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.