Individual provider Active NPI

Nancy Jean Carlisle, MS, RD, LD, CDE

  • Registered Dietitian
  • Iowa City, IA
National Provider Identifier
1467413807
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
00262 Issued in IA
Practice address
500 E Market St
Iowa City, IA 52245-2689
Phone
(319) 339-2678
Fax
(319) 688-7189
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 00262 IA Primary

Addresses

Primary practice location

500 E Market St
Iowa City, IA 52245-2689

Mailing address

500 E Market St
Iowa City, IA 52245-2689
Phone (319) 339-2678

Other names 1

  • Nancy Jean Schnack Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060411000509 IA Practitioner - Registered Dietitian Or Nutrition Professional 7012926504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Practice addresses (Care Compare)

1518 Mulberry Ave
Muscatine, IA 52761-3433

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00262IAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation CurrentSince Dec 1, 2021 Accepting new patients
Mercy Hospital, Iowa City, Iowa Dietitian, Registered Past Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

1518 Mulberry Ave
Muscatine, IA 52761
Phone (563) 262-4110

2701 17th St
Rock Island, IL 61201
Phone (309) 779-3200

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.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467413807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E MARKET ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452689",
            "telephone_number": "319-339-2678",
            "fax_number": "319-688-7189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E MARKET ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452689",
            "telephone_number": "319-339-2678",
            "fax_number": "319-688-7189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "NANCY",
        "middle_name": "JEAN",
        "credential": "MS, RD, LD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IA",
            "license": "00262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "SCHNACK",
            "middle_name": "JEAN",
            "credential": "MS, RD, LD, CDE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.