Alyssa Bethany Grace Tisdale, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

1521 Gull Rd
Kalamazoo, MI 49048-1640

Phone

(269) 226-7000

NPI assigned

Mar 30, 2021

Last updated

Apr 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1558949677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 LAURENS WAY",
            "city": "POTTERVILLE",
            "state": "MI",
            "postal_code": "488768786",
            "telephone_number": "517-668-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 GULL RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481640",
            "telephone_number": "269-226-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDALE",
        "first_name": "ALYSSA",
        "middle_name": "BETHANY GRACE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stanislav Yurievich Tinigin, DO
• Gregory P Tiongson, MD
• Nicole Tiongson
• Mikayla Nicole Tipken
• Justyce Tipton
• Ross E Tisron, NP
• Ankita Tiwari
• TLS Litchfield, LLC
• Heather Tobin
• Christopher S Todd, MD

• Registered Dietitian in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Registered Dietitian in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.