Individual provider Active NPI

Carla R Heiser

  • Registered Dietitian
  • Carmel, IN
National Provider Identifier
1578741013
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164003355 Issued in IL
Practice address
484 E Carmel Dr
Suite 154
Carmel, IN 46032-2812
Phone
(317) 753-5694
Fax
(866) 315-7638
NPI assigned
Feb 7, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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 164003355 IL Primary

Addresses

Primary practice location

484 E Carmel Dr
Suite 154
Carmel, IN 46032-2812

Mailing address

6400 Industrial Loop
Greendale, WI 53129-2452
Phone (414) 423-4100

Other identifiers 1

IdentifierTypeStateIssuer
164003355OtherILNUTRITIONAL DIETITIAN

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

State licenses

LicenseStateTypeSpecialty
164003355ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Bilstrom Pain and Health Services LLC CurrentSince Nov 12, 2012 Accepting new patients
Jeffrey K . Bergin, DC, Dabci, SC PastSince Nov 12, 2012 Accepting new patients

Locations

201 E Ogden Ave
Ste 115
Hinsdale, IL 60521
Phone (630) 325-2880

201 E Ogden Ave
Ste 1
Hinsdale, IL 60521

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": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1578741013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-423-4100",
            "fax_number": "144-234-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 E CARMEL DR",
            "address_2": "SUITE 154",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460322812",
            "telephone_number": "317-753-5694",
            "fax_number": "866-315-7638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISER",
        "first_name": "CARLA",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-07",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164003355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NUTRITIONAL DIETITIAN",
            "identifier": "164003355",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.