Active NPI
Chelsea Eismann Potter, RD
- Registered Dietitian
- Santa Maria, CA
National Provider Identifier
1114551991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86065917
- Practice address
- 110 N McClelland St
Santa Maria, CA 93454-4419 - Phone
- (805) 801-9692
- NPI assigned
- Mar 2, 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 | 86065917 | CA | Primary |
Addresses
Primary practice location
110 N McClelland St
Santa Maria, CA 93454-4419
Mailing address
1625 W Grand Ave
Grover Beach, CA 93433-2228
Phone (805) 801-9692
Other names 1
- Miss Chelsea Brianne Eismann
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201229002840 | CA | Practitioner - Registered Dietitian Or Nutrition Professional | 0446663934 | Practice locations: Grover Beach, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86065917 | CA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583107200000",
"number": "1114551991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1625 W GRAND AVE",
"city": "GROVER BEACH",
"state": "CA",
"postal_code": "934332228",
"telephone_number": "805-801-9692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 N MCCLELLAND ST",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934544419",
"telephone_number": "805-801-9692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "CHELSEA",
"middle_name": "EISMANN",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-02",
"last_updated": "2020-03-02",
"certification_date": "2020-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86065917",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CHELSEA",
"last_name": "EISMANN",
"middle_name": "BRIANNE",
"prefix": "MISS",
"credential": "RD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Santa Maria, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.