Active NPI
Terri P Elisberg, R.D.,L.D.,C.D.E.
- Registered Dietitian
- Tijeras, NM
National Provider Identifier
1881865558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 059
- Practice address
- 47 Villacitos Rd
Tijeras, NM 87059-6601 - Phone
- (505) 450-9961
- NPI assigned
- Mar 20, 2008
- Last updated
- Nov 2, 2011
- 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 | 059 | NM | Primary |
Addresses
Primary practice location
47 Villacitos Rd
Tijeras, NM 87059-6601
Mailing address
PO Box 998
Tijeras, NM 87059
Phone (505) 450-9961
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 059 | Other | NM | LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 059 | NM | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pueblo of Isleta | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320192000000",
"number": "1881865558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 998",
"city": "TIJERAS",
"state": "NM",
"postal_code": "87059",
"telephone_number": "505-450-9961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47 VILLACITOS RD",
"city": "TIJERAS",
"state": "NM",
"postal_code": "870596601",
"telephone_number": "505-450-9961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELISBERG",
"first_name": "TERRI",
"middle_name": "P",
"credential": "R.D.,L.D.,C.D.E.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-20",
"last_updated": "2011-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NM",
"license": "059",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "059",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tijeras, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.