Your Health Nutrition

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

YOUR HEALTH NUTRITION

Practice address

4907 Niagara Rd Ste 102
College Park, MD 20740-1100

Phone

(240) 215-3653

Fax

(888) 388-2830

NPI assigned

Mar 7, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa Euliss, RD, LDNNPI 1396018594

Title

Dietitian/ Owner

Phone

(301) 412-1307

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Marie Euliss, RD, LDN

  • Registered Dietitian
  • College Park, MD
  • NPI 1396018594

  Dietitian, Registered

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667433600000",
    "number": "1154078475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7109 LIMESTONE LN",
            "city": "MIDDLETOWN",
            "state": "MD",
            "postal_code": "217697534",
            "telephone_number": "301-412-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4907 NIAGARA RD STE 102",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207401100",
            "telephone_number": "240-215-3653",
            "fax_number": "888-388-2830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7109 Limestone Ln",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "MD",
            "postal_code": "217697534",
            "country_code": "US",
            "telephone_number": "301-412-1307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "YOUR HEALTH NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A",
        "authorized_official_last_name": "EULISS",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "DIETITIAN/ OWNER",
        "authorized_official_telephone_number": "301-412-1307",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RD, LDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in College Park, MD
• Providers in College Park, MD by specialty
• Registered Dietitian in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.

Verify at the official NPI Registry.