Individual provider Active NPI

Elaine Johnson, RDN LDN

  • Registered Dietitian
  • Erie, PA
National Provider Identifier
1285132662
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN002780 Issued in PA
Practice address
1745 W Grandview Blvd
Erie, PA 16509-1101
Phone
(814) 323-3920
Fax
(866) 316-2981
NPI assigned
Jan 31, 2018
Last updated
Aug 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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 DN002780 PA Primary

Addresses

Primary practice location

1745 W Grandview Blvd
Erie, PA 16509-1101

Mailing address

1745 W Grandview Blvd
Erie, PA 16509-1101
Phone (814) 323-3920

Other practice location 1

4512 Peach St Ste 2
Erie, PA 16509-1369
Phone (814) 426-1370 ext. 1

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240410002989 PA Practitioner - Registered Dietitian Or Nutrition Professional 6305284225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1998
Medicare assignment
May accept Medicare assignment
Group practices
Marke Nutrition LLCGroup PAC ID 5496193310, 2 clinicians

Practice addresses (Care Compare)

4512 Peach St
Erie, PA 16509-1369
Phone (814) 323-3920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN002780PAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Marke Nutrition LLC Dietitian, Registered CurrentSince Apr 2, 2024 Accepting new patients

Locations

1745 W Grandview Blvd
Erie, PA 16509
Phone (814) 323-3920

4512 Peach St
#2
Erie, PA 16509
Phone (814) 323-3920

4512 Peach St
Ste 2
Erie, PA 16509
Phone (814) 323-3920

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1285132662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 W GRANDVIEW BLVD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165091101",
            "telephone_number": "814-323-3920",
            "fax_number": "866-316-2981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 W GRANDVIEW BLVD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165091101",
            "telephone_number": "814-323-3920",
            "fax_number": "866-316-2981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4512 Peach St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165091369",
            "country_code": "US",
            "telephone_number": "814-426-1370 x1",
            "fax_number": "866-316-2981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ELAINE",
        "credential": "RDN LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-31",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN002780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; 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.