Kristen Ellis, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

2121 Baypointe Dr
Newport Beach, CA 92660-8518

Phone

(585) 313-2952

NPI assigned

Jun 14, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1104310036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 BAYPOINTE DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926608518",
            "telephone_number": "585-313-2952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 BAYPOINTE DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926608518",
            "telephone_number": "585-313-2952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "KRISTEN",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT135522",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "135522",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Pusey MD Inc (Womens Medical Imaging)
• Julia A Elizondo, PT, OCS
• Laila M. Elkeeb, MD
• Jordan Dulay Ellfeldt, OD
• Carrie Susanne Ellis, AGACNP
• Zackry Calvin Ellis, PA-C
• Christopher Lee Ellstrom, MD
• Mitra H Elmi
• Roak Gordon Ely II
• Em Beaute

• Registered Dietitian in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.

Verify at the official NPI Registry.