Active NPI
Lisa Marie Euliss, RD, LDN
- Registered Dietitian
- College Park, MD
National Provider Identifier
1396018594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DX3196
- Practice address
- 4907 Niagara Rd Ste 102
College Park, MD 20740-1100 - Phone
- (301) 412-1307
- NPI assigned
- Feb 17, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DX3196 | MD | Primary |
Addresses
Primary practice location
4907 Niagara Rd Ste 102
College Park, MD 20740-1100
Mailing address
7109 Limestone LN
Middletown, MD 21769-7534
Phone (301) 412-1307
Other practice location 1
7109 Limestone Ln
Middletown, MD 21769-7534
Phone (240) 215-3653
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, MD
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
7109 Limestone LN
Middletown, MD 21769-7534
Phone (240) 215-3653
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Your Health Nutrition | Dietitian, Registered | Current | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Locations
4907 Niagara Rd
Ste 102
College Park, MD 20740
Phone (240) 206-7575
Organizations & group practices 2
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.
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Berkeley Medical Center
- General Acute Care Hospital
- Martinsburg, WV
- NPI 1457389249
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667433600000",
"number": "1396018594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7109 LIMESTONE LN",
"city": "MIDDLETOWN",
"state": "MD",
"postal_code": "217697534",
"telephone_number": "301-412-1307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4907 NIAGARA RD STE 102",
"city": "COLLEGE PARK",
"state": "MD",
"postal_code": "207401100",
"telephone_number": "301-412-1307"
}
],
"practiceLocations": [
{
"address_1": "7109 Limestone Ln",
"address_purpose": "LOCATION",
"city": "Middletown",
"state": "MD",
"postal_code": "217697534",
"country_code": "US",
"telephone_number": "240-215-3653",
"fax_number": "888-388-2830",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EULISS",
"first_name": "LISA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "RD, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-17",
"last_updated": "2022-11-03",
"certification_date": "2022-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MD",
"license": "DX3196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.