Individual provider Active NPI

Skylar Nelson

  • Registered Dietitian
  • La Jolla, CA
National Provider Identifier
1275967424
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1025528 Issued in CA
Practice address
9850 Genesee Ave
Suite 730
La Jolla, CA 92037-1224
Phone
(626) 993-4042
NPI assigned
Aug 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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 1025528 CA Primary

Addresses

Primary practice location

9850 Genesee Ave
Suite 730
La Jolla, CA 92037-1224

Mailing address

9850 Genesee Ave
Suite 730
La Jolla, CA 92037-1224
Phone (626) 993-4042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ, VA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20140319001404 CA Practitioner - Registered Dietitian Or Nutrition Professional 5890926679 Reassigns benefits to 1 organization
I20251120003418 AZ Practitioner - Registered Dietitian Or Nutrition Professional 5890926679
I20260211001666 VA Practitioner - Registered Dietitian Or Nutrition Professional 5890926679

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

317 6TH Ave
Suite 400
Des Moines, IA 50309-4037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1025528CAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Openloop Healthcare Partners PC Dietitian, Registered CurrentSince Sep 14, 2025 Accepting new patients
Openloop Healthcare Partners California PC CurrentSince Aug 8, 2025 Accepting new patients
Openloop Healthcare Partners California PC Dietitian, Registered Current Accepting new patients
Openloop Healthcare Partners Colorado, PC Dietitian, Registered CurrentSince Sep 14, 2025 Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients
Openloop Healthcare Partners New Jersey PC Dietitian, Registered Past Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Locations

3707 E Southern Ave
#1
Mesa, AZ 85206
Phone (424) 387-6806

2121 E Coast Hwy
Ste 270
Corona del Mar, CA 92625
Phone (949) 694-4937

72650 Fred Waring Dr
Ste 106
Palm Desert, CA 92260
Phone (760) 230-9990

1600 Broadway
Ste 1600
Denver, CO 80202
Phone (970) 592-8970

317 6th Ave
Ste 400
Des Moines, IA 50309
Phone (515) 612-9097

3200 Greenfield Rd
Ste 300
Dearborn, MI 48120
Phone (313) 318-8208

101 Hudson St
Jersey City, NJ 07302
Phone (516) 432-3800

10260 SW Greenburg Rd
#4
Portland, OR 97223
Phone (513) 845-1656

4500 Mercantile Plaza Dr
Ste 300
Ft Worth, TX 76137
Phone (469) 688-9501

11815 Fountain Way
Ste 300
Newport News, VA 23606
Phone (757) 505-7574

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1275967424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE",
            "address_2": "SUITE 730",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371224",
            "telephone_number": "626-993-4042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE",
            "address_2": "SUITE 730",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371224",
            "telephone_number": "626-993-4042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SKYLAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-23",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1025528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.