Individual provider Active NPI

Danika G Ofelt, RD

  • Registered Dietitian
  • Corvallis, OR
National Provider Identifier
1346570280
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI60116670 Issued in WA
Practice address
922 NW Circle Blvd Ste 160-219
Corvallis, OR 97330-1483
Phone
(541) 243-3665
Fax
(541) 224-5277
NPI assigned
Dec 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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 DI60116670 WA Primary

Addresses

Primary practice location

922 NW Circle Blvd Ste 160-219
Corvallis, OR 97330-1483

Mailing address

922 NW Circle Blvd Ste 160-219
Corvallis, OR 97330-1483
Phone (541) 243-3665

Other practice location 1

4742 42nd Ave SW
#223
Seattle, WA 98116
Phone (206) 714-6906

Other identifiers 1

IdentifierTypeStateIssuer
500778042MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250130000212 OR Practitioner - Registered Dietitian Or Nutrition Professional 9830450063 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI60116670WAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Creating Nutrition, LLC Dietitian, Registered CurrentSince Dec 18, 2024 Accepting new patients

Locations

922 NW Circle Blvd
Ste 160219
Corvallis, OR 97330
Phone (541) 243-3665

2852 Willamette St
Eugene, OR 97405
Phone (541) 255-9061

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1261872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1346570280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 NW CIRCLE BLVD STE 160-219",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973301483",
            "telephone_number": "541-243-3665",
            "fax_number": "541-224-5277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 NW CIRCLE BLVD STE 160-219",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973301483",
            "telephone_number": "541-243-3665",
            "fax_number": "541-224-5277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4742 42nd Ave SW",
            "address_2": "#223",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "98116",
            "country_code": "US",
            "telephone_number": "206-714-6906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OFELT",
        "first_name": "DANIKA",
        "middle_name": "G",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-27",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI60116670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500778042",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; 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.

Verify at the official NPI Registry.