Active NPI
Wendy N Ellison, RD, RDN
- Registered Dietitian
- Medford, OR
National Provider Identifier
1659943256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86145556
- Practice address
- 2825 E Barnett Rd
Medford, OR 97504-8332 - Phone
- (541) 789-7000
- NPI assigned
- Jul 13, 2021
- 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 | 86145556 | OR | Primary |
Addresses
Primary practice location
2825 E Barnett Rd
Medford, OR 97504-8332
Mailing address
811 Morrison Ave Unit a
Medford, OR 97504-8455
Phone (360) 434-4700
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 |
|---|---|---|---|
| 86145556 | OR | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626134400000",
"number": "1659943256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "811 MORRISON AVE UNIT A",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975048455",
"telephone_number": "360-434-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2825 E BARNETT RD",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975048332",
"telephone_number": "541-789-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLISON",
"first_name": "WENDY",
"middle_name": "N",
"name_prefix": "Miss",
"credential": "RD, RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-13",
"last_updated": "2021-07-13",
"certification_date": "2021-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": "86145556",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.