Connie Elick, MS RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

4193 Flat Rock Drive Suite 200 Office #465
Riverside, CA 92505

Phone

(951) 223-1841

NPI assigned

Nov 17, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639180800000",
    "number": "1215694971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4193 FLAT ROCK DRIVE SUITE 200",
            "address_2": "OFFICE #465",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4193 FLAT ROCK DRIVE SUITE 200 OFFICE #465",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92505",
            "telephone_number": "951-223-1841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELICK",
        "first_name": "CONNIE",
        "credential": "MS RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-12-11",
        "certification_date": "2021-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Riverside, CA
• Providers in Riverside, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2021; 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.