Active NPI
Elisabeth C. Peterson, R.D.
- Registered Dietitian
- Henrico, VA
National Provider Identifier
1225302672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 839987
- Practice address
- 2200 Pump Rd
Henrico, VA 23233-3539 - Phone
- (804) 440-3110
- Fax
- (804) 377-9690
- NPI assigned
- Mar 2, 2012
- Last updated
- Mar 2, 2012
- 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 | 839987 | VA | Primary |
Addresses
Primary practice location
2200 Pump Rd
Henrico, VA 23233-3539
Mailing address
2306 Boulder Run CT
Henrico, VA 23238-3644
Phone (804) 440-3110
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 839987 | VA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330646400000",
"number": "1225302672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2306 BOULDER RUN CT",
"city": "HENRICO",
"state": "VA",
"postal_code": "232383644",
"telephone_number": "804-440-3110",
"fax_number": "804-377-9690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 PUMP RD",
"city": "HENRICO",
"state": "VA",
"postal_code": "232333539",
"telephone_number": "804-440-3110",
"fax_number": "804-377-9690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "ELISABETH",
"middle_name": "C.",
"name_prefix": "Ms.",
"credential": "R.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-02",
"last_updated": "2012-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "VA",
"license": "839987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henrico, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.