Individual provider Active NPI

Rachel Evon Elzinga, RD

  • Registered Dietitian
  • Bend, OR
National Provider Identifier
1053958116
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD-D-10185713 Issued in OR
Practice address
2036 NE Williamson CT
Bend, OR 97701-3771
Phone
(541) 706-6348
NPI assigned
Dec 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD-D-10185713 OR Primary

Addresses

Primary practice location

2036 NE Williamson CT
Bend, OR 97701-3771

Mailing address

1445 NW Division St Apt 5
Corvallis, OR 97330-4557
Phone (209) 679-2704

Other practice location 1

1445 NW Division St Apt 5
Corvallis, OR 97330-4557
Phone (209) 679-2704

Other practice location 2

271 N Egan Ave
Burns, OR 97720-1733
Phone (541) 573-4099

Other names 1

  • Rachel Evon Dell Former name

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address Rachel.elzinga@icloud.com Direct
Direct Messaging Address Rachel.elzinga@icloud.com Direct
Direct Messaging Address relzinga143217@secure.stcharleshealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220504002638 OR Practitioner - Registered Dietitian Or Nutrition Professional 5193112415 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

2036 NE Williamson CT
Bend, OR 97701-3771
Phone (541) 706-7721

211 NW Larch Ave
Family Care
Redmond, OR 97756-1357
Phone (541) 548-2164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LD-D-10185713ORMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. CurrentSince Jul 11, 2022 Accepting new patients
Harney District Hospital Current Accepting new patients
Harney District Hospital CurrentSince Apr 26, 2022 Accepting new patients
St. Charles Health System, Inc. CurrentSince Jul 11, 2022 Accepting new patients
Harney District Hospital CurrentSince Apr 26, 2022 Accepting new patients
Harney District Hospital Past Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

2036 NE Williamson Ct
Bend, OR 97701
Phone (541) 318-4249

2200 NE Neff Rd
Bend, OR 97701
Phone (541) 322-2323

271 N Egan Ave
Burns, OR 97720
Phone (541) 573-2301

559 W Washington St
Burns, OR 97720
Phone (541) 573-2074

557 W Washington St
Burns, OR 97720
Phone (541) 573-3682

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

Organizations & group practices 7

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": "1575590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1053958116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 NW DIVISION ST APT 5",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304557",
            "telephone_number": "209-679-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2036 NE WILLIAMSON CT",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013771",
            "telephone_number": "541-706-6348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1445 NW Division St Apt 5",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973304557",
            "country_code": "US",
            "telephone_number": "209-679-2704",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "271 N Egan Ave",
            "address_purpose": "LOCATION",
            "city": "Burns",
            "state": "OR",
            "postal_code": "977201733",
            "country_code": "US",
            "telephone_number": "541-573-4099",
            "fax_number": "541-573-8627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELZINGA",
        "first_name": "RACHEL",
        "middle_name": "EVON",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-06",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-10185713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Rachel.elzinga@icloud.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1445 NW Division St Apt 5",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973304557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Rachel.elzinga@icloud.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1445 NW Division St Apt 5",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973304557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "relzinga143217@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "2036 NE Williamson Ct",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977013771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "DELL",
            "middle_name": "EVON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.