Active NPI
Erva Santoso, RDN
- Registered Dietitian
- Fort Bliss, TX
National Provider Identifier
1962032045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1072186
- Practice address
- 18511 Highlander Medics St
Fort Bliss, TX 79906-5327 - Phone
- (718) 360-7472
- NPI assigned
- Jan 17, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 205-LD | HI | |
| Registered Dietitian | 133V00000X | 1072186 | Primary |
Addresses
Primary practice location
18511 Highlander Medics St
Fort Bliss, TX 79906-5327
Mailing address
11400 Edgemere Blvd Apt 3113
El Paso, TX 79936-2426
Phone (718) 360-7472
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 205-LD | HI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753747200000",
"number": "1962032045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11400 EDGEMERE BLVD APT 3113",
"city": "EL PASO",
"state": "TX",
"postal_code": "799362426",
"telephone_number": "718-360-7472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18511 HIGHLANDER MEDICS ST",
"city": "FORT BLISS",
"state": "TX",
"postal_code": "799065327",
"telephone_number": "718-360-7472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTOSO",
"first_name": "ERVA",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-17",
"last_updated": "2025-07-29",
"certification_date": "2025-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "HI",
"license": "205-LD",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "1072186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Bliss, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.