Active NPI
Leslie Carr Ely, RD, LDN, CEDRD
- Registered Dietitian
- Memphis, TN
National Provider Identifier
1629552633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2767
- Practice address
- 6263 Poplar Ave Ste 605
Memphis, TN 38119-4724 - Phone
- (901) 343-6146
- NPI assigned
- Sep 17, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2767 | TN | Primary |
Addresses
Primary practice location
6263 Poplar Ave Ste 605
Memphis, TN 38119-4724
Mailing address
6263 Poplar Ave Ste 605
Memphis, TN 38119-4724
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2767 | TN | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memphis Nutrition Group, LLC | Past | 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.
-
- Clinic/Center
- Memphis, TN
- NPI 1538799515
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537142400000",
"number": "1629552633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6263 POPLAR AVE STE 605",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381194724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6263 POPLAR AVE STE 605",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381194724",
"telephone_number": "901-343-6146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELY",
"first_name": "LESLIE",
"middle_name": "CARR",
"credential": "RD, LDN, CEDRD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-17",
"last_updated": "2018-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TN",
"license": "2767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.