Active NPI
Carly Austin, RD, LD
- Registered Dietitian
- Simi Valley, CA
National Provider Identifier
1922519321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86051182
- Practice address
- 543 Country Club Dr Ste B516
Simi Valley, CA 93065-0637 - Phone
- (805) 796-8436
- NPI assigned
- Oct 12, 2017
- Last updated
- Feb 8, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86051182 | TX | |
| Registered Dietitian | 133V00000X | DT86364 | TX | |
| Registered Dietitian | 133V00000X | 86051182 | CA | Primary |
Addresses
Primary practice location
543 Country Club Dr Ste B516
Simi Valley, CA 93065-0637
Mailing address
543 Country Club Dr Ste B516
Simi Valley, CA 93065-0637
Phone (805) 796-8436
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 |
|---|---|---|---|
| 86051182 | CA | MD | Registered Dietitian |
| 86051182 | TX | MD | Registered Dietitian |
| DT86364 | TX | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nutrition Partners in Health | Dietitian, Registered | Current | Accepting new patients |
| Healthy Eating and Training, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Locations
543 Country Club Dr
Ste B516
Simi Valley, CA 93065
Phone (805) 796-8436
Organizations & group practices 3
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.
-
- Registered Dietitian
- Simi Valley, CA
- NPI 1578245460
Dietitian, Registered
-
- Registered Dietitian
- Studio City, CA
- NPI 1144406992
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707350400000",
"number": "1922519321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "543 COUNTRY CLUB DR STE B516",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930650637",
"telephone_number": "805-796-8436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "543 COUNTRY CLUB DR STE B516",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930650637",
"telephone_number": "805-796-8436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUSTIN",
"first_name": "CARLY",
"credential": "RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-12",
"last_updated": "2024-02-08",
"certification_date": "2024-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "86051182",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT86364",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86051182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Simi Valley, CA
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- Aurum Health (Aspen Treatment Center)
- Dionne Melody Austria, FNP-BC, FNP-C
- Maria Dolores Chua Austria, DDS
- Vanessa Avalos
- Sargis Avanesyan, RPH
- Jeffrey Alan Avants, MA, LMFT, CADC II,
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.