Individual provider Active NPI

Terri Will, MBA, RDN, LDN

  • Registered Dietitian
  • Erie, PA
National Provider Identifier
1417490921
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN004213 Issued in PA
Practice address
1745 W Grandview Blvd
Erie, PA 16509-1101
Phone
(814) 426-1370
Fax
(866) 316-2981
NPI assigned
Dec 1, 2016
Last updated
Aug 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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 DN004213 PA Primary

Addresses

Primary practice location

1745 W Grandview Blvd
Erie, PA 16509-1101

Mailing address

10130 Wattsburg Rd
Erie, PA 16509-6124
Phone (724) 777-1935

Other practice location 1

4512 Peach St # 2
Erie, PA 16509-1369
Phone (814) 426-1370

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240620003617 PA Practitioner - Registered Dietitian Or Nutrition Professional 5092258855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Marke Nutrition LLCGroup PAC ID 5496193310, 2 clinicians

Practice addresses (Care Compare)

4512 Peach St
Erie, PA 16509-1369
Phone (814) 323-3920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

Practice roles

OrganizationSpecialtyStatusNew patients
Marke Nutrition LLC Dietitian, Registered CurrentSince Jun 1, 2024 Accepting new patients

Locations

100 Insurance Pl
Erie, PA 16530

1745 W Grandview Blvd
Erie, PA 16509
Phone (814) 323-3920

4512 Peach St
#2
Erie, PA 16509
Phone (814) 323-3920

4512 Peach St
Ste 2
Erie, PA 16509
Phone (814) 323-3920

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1480550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1417490921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10130 WATTSBURG RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165096124",
            "telephone_number": "724-777-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 W GRANDVIEW BLVD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165091101",
            "telephone_number": "814-426-1370",
            "fax_number": "866-316-2981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4512 Peach St # 2",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165091369",
            "country_code": "US",
            "telephone_number": "814-426-1370",
            "fax_number": "866-316-2981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILL",
        "first_name": "TERRI",
        "credential": "MBA, RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-01",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN004213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; 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.

Verify at the official NPI Registry.