Individual provider Active NPI

Elizabeth A Neumann, R.D., L.D.

  • Registered Dietitian
  • Willow Park, TX
National Provider Identifier
1578745501
Registry record updated Jul 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT80298 Issued in TX
Practice address
110 Pony Express TRL
Willow Park, TX 76087-3132
Phone
(817) 995-4677
NPI assigned
Nov 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2012

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 DT80298 TX Primary

Addresses

Primary practice location

110 Pony Express TRL
Willow Park, TX 76087-3132

Mailing address

110 Pony Express TRL
Willow Park, TX 76087-3132
Phone (817) 995-4677

Other identifiers 2

IdentifierTypeStateIssuer
194778001MedicaidTX
8AH959OtherTXBLUE CROSS BLUE SHIELD

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
DT80298TXMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
American Health Assessments LLC Dietitian, Registered PastSince Oct 27, 2012 Accepting new patients

Organizations & group practices 1

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": "1196380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341273600000",
    "number": "1578745501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PONY EXPRESS TRL",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "760873132",
            "telephone_number": "817-995-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PONY EXPRESS TRL",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "760873132",
            "telephone_number": "817-995-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUMANN",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "R.D., L.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-30",
        "last_updated": "2012-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT80298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194778001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8AH959",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; 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.