Active NPI
Madyson Elise Parker, R.D.
- Registered Dietitian
- Eldorado, IL
National Provider Identifier
1528611613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86066959
- Practice address
- 1200 Pine St
Eldorado, IL 62930-1635 - Phone
- (618) 273-3361
- NPI assigned
- Jul 18, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | |||
| Registered Dietitian | 133V00000X | 86066959 | Primary |
Addresses
Primary practice location
1200 Pine St
Eldorado, IL 62930-1635
Mailing address
1200 Pine St
Eldorado, IL 62930-1635
Phone (618) 273-3361
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608163200000",
"number": "1528611613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 PINE ST",
"city": "ELDORADO",
"state": "IL",
"postal_code": "629301635",
"telephone_number": "618-273-3361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 PINE ST",
"city": "ELDORADO",
"state": "IL",
"postal_code": "629301635",
"telephone_number": "618-273-3361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER",
"first_name": "MADYSON",
"middle_name": "ELISE",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-18",
"last_updated": "2020-12-17",
"certification_date": "2020-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "86066959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eldorado, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.