Sara Elizabeth Poulsen, RDN, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

D-897 Issued in ID

Practice address

147 Stanford Ave
Pocatello, ID 83201-3425

Phone

(208) 424-0179

NPI assigned

Aug 25, 2017

Last updated

Sep 22, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Four Pillars Nutrition and Wellness, LLC

  • Registered Dietitian
  • Pocatello, ID
  • NPI 1477333599

  Dietitian, Registered

  NPD Authorized official
• Atropos Mental Health LLC

  • Community/Behavioral Health Agency
  • Pocatello, ID
  • NPI 1316551187
  NPD (past)
• Better Health and Healing

  • Clinic/Center
  • Pocatello, ID
  • NPI 1568184174
  NPD (past)
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1346767746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 STANFORD AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832013425",
            "telephone_number": "208-424-0179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 STANFORD AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832013425",
            "telephone_number": "208-424-0179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "353 N 4th Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Pocatello",
            "state": "ID",
            "postal_code": "832016391",
            "country_code": "US",
            "telephone_number": "208-649-4171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POULSEN",
        "first_name": "SARA",
        "middle_name": "ELIZABETH",
        "credential": "RDN, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ID",
            "license": "D-897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Portneuf Valley Family Center
• Portneuf Valley Family Center
• Elizabeth Poteat
• Charity Potter, LCPC, LSW
• Elena Angelita Potter, DPT
• Luke Adam Poulter, D.O.
• Anthony Baden Powell, PTA
• Erica Powell
• Christina Michelle Powers, DNP, APRN, FNP-BC
• Pray Counseling, LLC

• Registered Dietitian in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Registered Dietitian in Idaho

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

Verify at the official NPI Registry.