Active NPI
Chelsea Elizabeth Stephens, RDN, LD
- Registered Dietitian
- Canton, GA
National Provider Identifier
1104428952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD005580
- Practice address
- 138 Registry LN
Canton, GA 30115-2323 - Phone
- (770) 855-6678
- NPI assigned
- Nov 16, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD005580 | GA | Primary |
Addresses
Primary practice location
138 Registry LN
Canton, GA 30115-2323
Mailing address
138 Registry LN
Canton, GA 30115-2323
Phone (770) 855-6678
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 86114183 | Other | COMMISSION ON DIETETIC REGISTRATION | |
| LD005580 | Other | GA | GEORGIA BOARD OF EXAMINERS OF LICENSED DIETITIANS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD005580 | GA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Veritas Collaborative Atlanta, LLC Dba the Emily Program | Past | Accepting new patients | |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Veritas Collaborative Georgia, LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Dunwoody, GA
- NPI 1609386614
-
- Psychiatric Hospital
- Dunwoody, GA
- NPI 1487197026
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605484800000",
"number": "1104428952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "138 REGISTRY LN",
"city": "CANTON",
"state": "GA",
"postal_code": "301152323",
"telephone_number": "770-855-6678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "138 REGISTRY LN",
"city": "CANTON",
"state": "GA",
"postal_code": "301152323",
"telephone_number": "770-855-6678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENS",
"first_name": "CHELSEA",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "RDN, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-16",
"last_updated": "2020-11-16",
"certification_date": "2020-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD005580",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMISSION ON DIETETIC REGISTRATION",
"identifier": "86114183",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEORGIA BOARD OF EXAMINERS OF LICENSED DIETITIANS",
"identifier": "LD005580",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.