Cynthia A Carlson, RD,LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164000634 Issued in IL

Practice address

10432 Linder Ave
Oak Lawn, IL 60453-4639

Phone

(773) 425-2706

Fax

(773) 296-1527

NPI assigned

Jul 11, 2012

Last updated

Jul 16, 2015By 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 7

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jefferson Park Medical Group PCGroup PAC ID 6204731474, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

Locations

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.

• Jefferson Park Medical Group, P.C.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1366490047
  Medicare reassignment Care Compare group NPD
• Fay Nutrition

  • Registered Dietitian
  • San Francisco, CA
  • NPI 1104334465

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1477818748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3339 N BELL AVE",
            "address_2": "UNIT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60618",
            "telephone_number": "773-425-2706",
            "fax_number": "773-296-1527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10432 LINDER AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604534639",
            "telephone_number": "773-425-2706",
            "fax_number": "773-296-1527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "CYNTHIA",
        "middle_name": "A",
        "credential": "RD,LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "132700000X",
            "taxonomy_group": "",
            "desc": "Dietary Manager",
            "state": "IL",
            "license": "164000634",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "IL",
            "license": "164000634",
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "IL",
            "license": "164000634",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164000634",
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "IL",
            "license": "164000634",
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "IL",
            "license": "164000634",
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "IL",
            "license": "164000634",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina M Caraballo, PA-C
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• Cardiovascular Surgeons LTD
• Rebecca Carlson, LCSW
• Meaghan Reich Carnevale, CRNP
• Carney Speech & Feeding LLC
• Katie Eileen Carney, M.S., CCC-SLP
• Rianda Rae Carodine

• Registered Dietitian in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.