Individual provider Active NPI

Elise Aasemarie Davidson

  • Registered Dietitian
  • St Louis Park, MN
National Provider Identifier
1821908971
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
6121 Issued in MN
Practice address
5354 Parkdale Dr FL 3
St Louis Park, MN 55416-1603
Phone
(888) 272-0814
NPI assigned
Sep 10, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 6121 MN Primary

Addresses

Primary practice location

5354 Parkdale Dr FL 3
St Louis Park, MN 55416-1603

Mailing address

1295 Bandana Blvd N Ste 210
Saint Paul, MN 55108-5115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1821908971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 BANDANA BLVD N STE 210",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5354 PARKDALE DR FL 3",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161603",
            "telephone_number": "888-272-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "ELISE",
        "middle_name": "AASEMARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-10",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "6121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.