Carrie Gonzalez, MPH, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

3467 Issued in MN

Practice address

3525 Monterey Dr
St Louis Park, MN 55416-5275

Phone

(952) 993-6200

NPI assigned

Jan 5, 2015

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

Other names 1

• Carrie Dent Former name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Famelia, Inc.

  • Registered Dietitian
  • Minneapolis, MN
  • NPI 1013892801

  Dietitian, Registered

  Medicare reassignment NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  Medicare reassignment

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1366830952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 MONTEREY DR",
            "address_2": "2ND FLOOR CLINICAL COMMONS",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 MONTEREY DR",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165275",
            "telephone_number": "952-993-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "CARRIE",
        "credential": "MPH, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-05",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "3467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "DENT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susanna Goldstein
• Ross Golla, PA
• Lauren Gonyea
• Maria Teresa Gonzalez Bolanos, M.D.
• Annmarie Gonzalez, OTR
• Good Clinic MN PLLC
• Good Samaritan Care Center LLC
• Leah Simone Good, NP
• Samuel Thomas Goracke, CNP
• Carolyn M Gordon

• Registered Dietitian in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Registered Dietitian in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.