Active NPI
Elyssa Mulheron Pattillo, MHS, RD, LDN
- Registered Dietitian
- Brevard, NC
National Provider Identifier
1700465895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86065017
- Practice address
- 925 Pine Shore Dr
Brevard, NC 28712-7941 - Phone
- (828) 774-7309
- NPI assigned
- Apr 6, 2021
- 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 | 86065017 | NC | Primary |
Addresses
Primary practice location
925 Pine Shore Dr
Brevard, NC 28712-7941
Mailing address
925 Pine Shore Dr
Brevard, NC 28712-7941
Phone (866) 772-0267
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 |
|---|---|---|---|
| 86065017 | NC | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618444800000",
"number": "1700465895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "925 PINE SHORE DR",
"city": "BREVARD",
"state": "NC",
"postal_code": "287127941",
"telephone_number": "866-772-0267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 PINE SHORE DR",
"city": "BREVARD",
"state": "NC",
"postal_code": "287127941",
"telephone_number": "828-774-7309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTILLO",
"first_name": "ELYSSA",
"middle_name": "MULHERON",
"credential": "MHS, RD, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-06",
"last_updated": "2021-04-15",
"certification_date": "2021-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "86065017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brevard, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.