Active NPI
Phyllis Ann Nelson, RD, LD, CDE
- Registered Dietitian
- Azle, TX
National Provider Identifier
1659491207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT02276
- Practice address
- 108 Denver Trail
Harris Methodist Northwest Hospital
Azle, TX 76020 - Phone
- (817) 444-8743
- Fax
- (817) 270-1369
- NPI assigned
- Mar 29, 2007
- 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 | DT02276 | TX | Primary |
Addresses
Primary practice location
108 Denver Trail
Harris Methodist Northwest Hospital
Azle, TX 76020
Mailing address
209 Classic CT
Springtown, TX 76082-7281
Phone (817) 444-8743
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 |
|---|---|---|---|
| DT02276 | TX | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206403200000",
"number": "1659491207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 CLASSIC CT",
"city": "SPRINGTOWN",
"state": "TX",
"postal_code": "760827281",
"telephone_number": "817-444-8743",
"fax_number": "817-270-1369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 DENVER TRAIL",
"address_2": "HARRIS METHODIST NORTHWEST HOSPITAL",
"city": "AZLE",
"state": "TX",
"postal_code": "76020",
"telephone_number": "817-444-8743",
"fax_number": "817-270-1369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "PHYLLIS",
"middle_name": "ANN",
"credential": "RD, LD, CDE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-29",
"last_updated": "2008-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT02276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Azle, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.