Elena Oh, MS. RDN. LDN, CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164005443 Issued in IL

Practice address

2316 Pebblestone Way
Bolingbrook, IL 60490-5059

Phone

(877) 443-5227

Fax

(888) 557-0978

NPI assigned

May 11, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Elena Stone Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Hillside Family and Community Medicine, LLC

  • Family Medicine Physician
  • Pawtucket, RI
  • NPI 1063501864
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1972718245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2316 PEBBLESTONE WAY",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604905059",
            "telephone_number": "401-829-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2316 PEBBLESTONE WAY",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604905059",
            "telephone_number": "877-443-5227",
            "fax_number": "888-557-0978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 Danielson Pike",
            "address_2": "Unit B",
            "address_purpose": "LOCATION",
            "city": "North Scituate",
            "state": "RI",
            "postal_code": "028571877",
            "country_code": "US",
            "telephone_number": "401-934-3545",
            "fax_number": "401-934-0671",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "737 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232191441",
            "country_code": "US",
            "telephone_number": "877-443-5227 x1460",
            "fax_number": "888-557-0978",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6170 Research Rd",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "750332878",
            "country_code": "US",
            "telephone_number": "877-443-5227 x1460",
            "fax_number": "888-557-0978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OH",
        "first_name": "ELENA",
        "name_prefix": "Ms.",
        "credential": "MS. RDN. LDN, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164005443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTI PLAN PROVIDER",
            "identifier": "05-0466452",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HA00033",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELENA",
            "last_name": "STONE",
            "credential": "MS RDN LDN CDE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Dietitian in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.