Elyse Marie Carson, MS RD LD

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

License

DTO5996 Issued in TX

Practice address

6135 La Vista Dr
Dallas, TX 75214-4310

Phone

(214) 773-6858

NPI assigned

Sep 13, 2006

Last updated

Feb 21, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Mrs. Elyse Marie Tyler Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1396840856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6135 LA VISTA DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752144310",
            "telephone_number": "214-773-6858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6135 LA VISTA DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752144310",
            "telephone_number": "214-773-6858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "ELYSE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MS RD LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "TX",
            "license": "DTO5996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS LICENSURE",
            "identifier": "DTO5996",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143738601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDR",
            "identifier": "896525",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELYSE",
            "last_name": "TYLER",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "credential": "MS RD LD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa Carry, M.D.
• Mario F Carsello Jr., CRNA
• Bethany J Carson
• Christine Carson, LPC-ASSOCIATE
• Cody Kent Carson
• Raequael Carson, M.S., LPC, BCBA, LBA
• Rachael Carstens, MD
• Carter Home Health LLC
• Carter Optical Inc
• Essence Monee Carter-Griffin

• Pediatric Nutrition Registered Dietitian in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatric Nutrition Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.