Active NPI
Elisa Warren, MS, RDN, LD
- Registered Dietitian
- Plymouth, MN
National Provider Identifier
1871328898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 5149
- Practice address
- 4625 Juneau LN N
Plymouth, MN 55446-3402 - Phone
- (612) 805-5538
- NPI assigned
- Sep 9, 2024
- 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 | 5149 | MN | Primary |
Addresses
Primary practice location
4625 Juneau LN N
Plymouth, MN 55446-3402
Mailing address
4625 Juneau LN N
Plymouth, MN 55446-3402
Phone (612) 805-5538
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)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785196800000",
"number": "1871328898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4625 JUNEAU LN N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554463402",
"telephone_number": "612-805-5538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4625 JUNEAU LN N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554463402",
"telephone_number": "612-805-5538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARREN",
"first_name": "ELISA",
"credential": "MS, RDN, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-09",
"last_updated": "2026-07-28",
"certification_date": "2026-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MN",
"license": "5149",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.