Active NPI
Kelsi Evans, R.D.
- Registered Dietitian
- Springfield, IL
National Provider Identifier
1972047348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164005728
- Practice address
- 932 N Rutledge St
Springfield, IL 62702-3721 - Phone
- (217) 788-3948
- NPI assigned
- Dec 5, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164005728 | IL | Primary |
Addresses
Primary practice location
932 N Rutledge St
Springfield, IL 62702-3721
Mailing address
932 N Rutledge St
Springfield, IL 62702-3721
Phone (217) 788-3948
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1076575 | Other | IL | CDR |
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 |
|---|---|---|---|
| 164005728 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Medical Center | Dietitian, Registered | 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 and National Provider Directory roles.
-
- Certified Registered Nurse Anesthetist
- Springfield, IL
- NPI 1255393112
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480896000000",
"number": "1972047348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "932 N RUTLEDGE ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627023721",
"telephone_number": "217-788-3948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "932 N RUTLEDGE ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627023721",
"telephone_number": "217-788-3948"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "KELSI",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-05",
"last_updated": "2016-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164005728",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDR",
"identifier": "1076575",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.