Individual provider Active NPI

Kelsi Brock Sellers, RDN

  • Obesity and Weight Management Nutrition Registered Dietitian
  • Carson, CA
National Provider Identifier
1881418879
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X
Practice address
20500 Belshaw Ave # Exca1377
Carson, CA 90746-3506
Phone
(415) 989-1017
NPI assigned
Nov 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Health Educator 174H00000X
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X AL Primary
Health & Wellness Coach 171400000X

Addresses

Primary practice location

20500 Belshaw Ave # Exca1377
Carson, CA 90746-3506

Mailing address

20500 Belshaw Ave # Exca1377
Carson, CA 90746-3506
Phone (415) 989-1017

Other names 1

  • Kelsi Laurell Brock Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vida Medical of Delaware PA Health & Wellness Coach CurrentSince Nov 17, 2024 Accepting new patients
Nourish, Inc. Past Accepting new patients
Strategic Nutrition Past Accepting new patients
Henry Ford Health Rochester Hospital Past Accepting new patients
Cloud Health Medical Group of New Jersey, P.C. Past Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients
Everfit Inc Past Accepting new patients

Locations

20500 Belshaw Ave
#1377
Carson, CA 90746
Phone (415) 989-1017

Organizations & group practices 7

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": "1731542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1881418879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20500 BELSHAW AVE # EXCA1377",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907463506",
            "telephone_number": "415-989-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20500 BELSHAW AVE # EXCA1377",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907463506",
            "telephone_number": "415-989-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "KELSI",
        "middle_name": "BROCK",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-14",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "AL",
            "license": null,
            "primary": true
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSI",
            "last_name": "BROCK",
            "middle_name": "LAURELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.