Active NPI
Clarissa Jane Dilaveris, RD, LD
- Registered Dietitian
- Columbus, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD.7440
- Practice address
- 1160 W Broad St
Columbus, OH 43222-1352 - Phone
- (614) 274-1455
- Fax
- (614) 274-1433
- NPI assigned
- Mar 9, 2020
- Last updated
- Nov 1, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT85859 | TX | |
| Registered Dietitian | 133V00000X | LD.7440 | OH | Primary |
Addresses
Primary practice location
1160 W Broad St
Columbus, OH 43222-1352
Mailing address
2990 Bissonnet St Apt 11102
Houston, TX 77005-4074
Phone (614) 907-3022
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD.7440 | OH | MD | Registered Dietitian |
| DT85859 | TX | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lower Lights Christian Health Center, Inc. | Current | Accepting new patients | |
| Lower Lights Christian Health Center, Inc. | Current | Accepting new patients | |
| Lower Lights Christian Health Center, Inc | Current | Accepting new patients | |
| Lower Lights Christian Health Center Inc | Current | Accepting new patients | |
| Lower Lights Christian Health Center, Inc | Current | Accepting new patients | |
| Lower Lights Christian Health Center, Inc | Current | Accepting new patients | |
| Lower Lights Christian Health Center Inc | Current | Accepting new patients | |
| Lower Lights Christian Health Center Inc | Current | Accepting new patients |
Locations
1160 W Broad St
Columbus, OH 43222
Phone (614) 947-7615
L3957
Columbus, OH 43260
Interoperability endpoints
- cdilaveris630771@direct.ochin.org
Organizations & group practices 8
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Primary Care Clinic/Center
- Columbus, OH
- NPI 1033455209
-
- Clinic/Center
- Newark, OH
- NPI 1700549755
-
- Clinic/Center
- Columbus, OH
- NPI 1992460950
-
- Clinic/Center
- Columbus, OH
- NPI 1992468938
-
dba Union Star Health Center
- Primary Care Clinic/Center
- Marysville, OH
- NPI 1699114108
-
dba German Village Health Center
- Primary Care Clinic/Center
- Columbus, OH
- NPI 1841611688
-
dba Vineyard Cooper Rd Health Center
- Primary Care Clinic/Center
- Westerville, OH
- NPI 1962823708
-
- Primary Care Clinic/Center
- Columbus, OH
- NPI 1154630408
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698796800000",
"number": "1275168411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2990 BISSONNET ST APT 11102",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770054074",
"telephone_number": "614-907-3022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1160 W BROAD ST",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432221352",
"telephone_number": "614-274-1455",
"fax_number": "614-274-1433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILAVERIS",
"first_name": "CLARISSA",
"middle_name": "JANE",
"credential": "RD, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-09",
"last_updated": "2023-11-01",
"certification_date": "2023-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT85859",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "LD.7440",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; 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.