Active NPI
Elisa Anne Rodriguez, RDN, LDN
- Registered Dietitian
- Buckeye, AZ
National Provider Identifier
1811396997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN003417
- Practice address
- 2886 N Heritage St
Buckeye, AZ 85396-1522 - Phone
- (717) 682-7729
- NPI assigned
- Aug 14, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | DN003417 | PA | |
| Registered Dietitian | 133V00000X | DN003417 | PA | Primary |
Addresses
Primary practice location
2886 N Heritage St
Buckeye, AZ 85396-1522
Mailing address
2886 N Heritage St
Buckeye, AZ 85396-1522
Phone (717) 682-7729
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 |
|---|---|---|---|
| DN003417 | PA | MD | Nutritionist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Nutrition Consulting, PLLC | 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.
-
- Health Service Clinic/Center
- Buckeye, AZ
- NPI 1619386596
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407974400000",
"number": "1811396997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2886 N HERITAGE ST",
"city": "BUCKEYE",
"state": "AZ",
"postal_code": "853961522",
"telephone_number": "717-682-7729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2886 N HERITAGE ST",
"city": "BUCKEYE",
"state": "AZ",
"postal_code": "853961522",
"telephone_number": "717-682-7729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "ELISA",
"middle_name": "ANNE",
"credential": "RDN, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-14",
"last_updated": "2014-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "PA",
"license": "DN003417",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN003417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buckeye, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.