NPIMap

Organization Active NPI

Elizabeth Hugo RDN LD

  • Registered Dietitian
  • Post Falls, ID
National Provider Identifier
1710496906
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
ELIZABETH HUGO RDN LD
Practice address
1125 E Polston Ave Ste B
Post Falls, ID 83854-6045
Phone
(208) 666-2559
NPI assigned
Sep 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Elizabeth Hugo, RDNNPI 1386071603
Title
Owner Provider
Phone
(208) 666-2559

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

1125 E Polston Ave Ste B
Post Falls, ID 83854-6045

Mailing address

1125 E Polston Ave Ste B
Post Falls, ID 83854-6045
Phone (208) 640-4502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171102001751 ID Part B Supplier - Clinic/Group Practice 1658637905 Receives reassigned benefits from 3 practitioners
Practice locations: Post Falls, ID

National Provider Directory

National Provider Directory

Locations

1110 W Ironwood Dr
Coeur D Alene, ID 83814
Phone (208) 666-0909

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1710496906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 E POLSTON AVE STE B",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838546045",
            "telephone_number": "208-640-4502",
            "fax_number": "208-777-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 E POLSTON AVE STE B",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838546045",
            "telephone_number": "208-666-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH HUGO RDN LD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-20",
        "last_updated": "2022-07-21",
        "certification_date": "2021-07-28",
        "status": "A",
        "authorized_official_last_name": "HUGO",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER PROVIDER",
        "authorized_official_telephone_number": "208-666-2559",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.