Individual provider Active NPI

Elsa Elena Kenworthy, MS, RD,, LDN, CDE

  • Registered Dietitian
  • Plano, TX
National Provider Identifier
1124157508
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT05626 Issued in TX
Practice address
6200 W Parker Rd
Plano, TX 75093-7939
Phone
(972) 981-8116
Fax
(972) 981-8453
NPI assigned
Mar 3, 2007
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 DT05626 TX Primary

Addresses

Primary practice location

6200 W Parker Rd
Plano, TX 75093-7939

Mailing address

1807 Childress LN
Allen, TX 75013-5330
Phone (972) 390-8144

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DT05626TXMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124157508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 CHILDRESS LN",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750135330",
            "telephone_number": "972-390-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 W PARKER RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750937939",
            "telephone_number": "972-981-8116",
            "fax_number": "972-981-8453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENWORTHY",
        "first_name": "ELSA",
        "middle_name": "ELENA",
        "name_prefix": "Mrs.",
        "credential": "MS, RD,, LDN, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT05626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

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.