Rachel Elizabeth Tisdale, REGISTERED DIETITIAN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86077854 Issued in FL

Practice address

8251 Laurel Lakes Way
Naples, FL 34119-6793

Phone

(254) 458-6647

NPI assigned

Feb 1, 2023

Last updated

Feb 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Rachel E Tisdale Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blossom Nutrition Services

  • Nutritionist
  • Naples, FL
  • NPI 1134827900
  NPD Authorized official

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

{
    "created_epoch": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1003512179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8251 LAUREL LAKES WAY",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341196793",
            "telephone_number": "254-458-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8251 LAUREL LAKES WAY",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341196793",
            "telephone_number": "254-458-6647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDALE",
        "first_name": "RACHEL",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "86077854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "TISDALE",
            "middle_name": "E",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Timeless Bodies
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• Lori Jean Tinney, M.A.,CCC-SLP
• Amber Tipton
• Titov Dental PA (Marsh Cove Dental)
• Titov Dental, P.a. (Marsh Cove Dental)
• Evgeny Titov
• Solnes A Tobal, MD
• Robert Boyd Tober, MD

• Registered Dietitian in Naples, FL
• Providers in Naples, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.