Individual provider Active NPI

Emily Prouse, R.D., L.D.

  • Registered Dietitian
  • Emporia, KS
National Provider Identifier
1932501467
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1344 Issued in KS
Practice address
1512 W 6TH Ave Ste B
Emporia, KS 66801-2400
Phone
(620) 208-6577
Fax
(620) 412-8954
NPI assigned
Sep 16, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1344 KS Primary

Addresses

Primary practice location

1512 W 6TH Ave Ste B
Emporia, KS 66801-2400

Mailing address

1512 W 6TH Ave Ste B
Emporia, KS 66801-2400
Phone (620) 208-6577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230208000339 KS Practitioner - Registered Dietitian Or Nutrition Professional 1456722537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1512 W 6TH Ave
Suite B
Emporia, KS 66801-2400
Phone (620) 208-6577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1344KSMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Brave Counseling and Consultation LLC CurrentSince Jan 25, 2023 Accepting new patients

Locations

1512 W 6th Ave
Ste B
Emporia, KS 66801
Phone (620) 208-6577

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": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1932501467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 W 6TH AVE STE B",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668012400",
            "telephone_number": "620-208-6577",
            "fax_number": "620-412-8954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 W 6TH AVE STE B",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668012400",
            "telephone_number": "620-208-6577",
            "fax_number": "620-412-8954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROUSE",
        "first_name": "EMILY",
        "credential": "R.D., L.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KS",
            "license": "1344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emporia, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.