Individual provider Active NPI

Carly Austin, RD, LD

  • Registered Dietitian
  • Simi Valley, CA
National Provider Identifier
1922519321
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86051182 Issued in CA
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, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
86051182CAMDRegistered Dietitian
86051182TXMDRegistered Dietitian
DT86364TXMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrition Partners in Health Dietitian, Registered CurrentSince Feb 11, 2024 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.

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

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.

Verify at the official NPI Registry.