Individual provider Active NPI

Erika Kristine Dycus, RN LDN

  • Nutritionist
  • Crystal Lake, IL
National Provider Identifier
1467147140
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
164009162 Issued in IL
Practice address
2387 Achilles CT
Crystal Lake, IL 60014-3932
Phone
(815) 451-9367
NPI assigned
Apr 7, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
NutritionistGroup: 193400000X SINGLE SPECIALTY GROUP 133N00000X
Nutritionist 133N00000X 164009162 IL Primary

Addresses

Primary practice location

2387 Achilles CT
Crystal Lake, IL 60014-3932

Mailing address

4119 Dean St
Woodstock, IL 60098-7501
Phone (815) 451-9367

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240322003074 IL Practitioner - Registered Dietitian Or Nutrition Professional 9436596699 Practice locations: Woodstock, IL

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
New York Chiropractic College, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

Woodstock, IL 60098
Phone (815) 451-9367

4119 Dean St
Woodstock, IL 60098-7501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Barefoot Nurse Nutritionist, LLC Nutritionist CurrentSince Feb 4, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1680825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1467147140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4119 DEAN ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600987501",
            "telephone_number": "815-451-9367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2387 ACHILLES CT",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143932",
            "telephone_number": "815-451-9367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYCUS",
        "first_name": "ERIKA",
        "middle_name": "KRISTINE",
        "name_prefix": "Mrs.",
        "credential": "RN LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-07",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "IL",
            "license": "164009162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.