Active NPI
Carla R Heiser
- Registered Dietitian
- Carmel, IN
National Provider Identifier
1578741013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164003355
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 164003355 | Other | IL | NUTRITIONAL 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
| License | State | Type | Specialty |
|---|---|---|---|
| 164003355 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bilstrom Pain and Health Services LLC | Current | Accepting new patients | |
| Jeffrey K . Bergin, DC, Dabci, SC | Past | 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.
-
- Internal Medicine Physician
- Hinsdale, IL
- NPI 1811055056
-
- Internist Chiropractor
- Zion, IL
- NPI 1538224118
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.