Individual provider Active NPI

Cynthia Denise Eldridge-Davis, R.D.

  • Registered Dietitian
  • Kansas City, MO
National Provider Identifier
1104856632
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2001021958 Issued in MO
Practice address
2400 Troost Ave
Kansas City, MO 64108-2666
Phone
(816) 513-6281
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2001021958 MO Primary

Addresses

Primary practice location

2400 Troost Ave
Kansas City, MO 64108-2666

Mailing address

5613 NE San Rafael Dr
Kansas City, MO 64119-4130
Phone (816) 216-7525

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2001021958MOMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104856632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5613 NE SAN RAFAEL DR",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641194130",
            "telephone_number": "816-216-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 TROOST AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082666",
            "telephone_number": "816-513-6281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDRIDGE-DAVIS",
        "first_name": "CYNTHIA",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2001021958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.