Ellie Rock, RDN, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

D-626 Issued in ID

Practice address

5424 N Sun Shimmer Ave
Meridian, ID 83646-5536

Phone

(208) 351-4640

NPI assigned

Sep 14, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1992310148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5424 N SUN SHIMMER AVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465536",
            "telephone_number": "208-351-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5424 N SUN SHIMMER AVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465536",
            "telephone_number": "208-351-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCK",
        "first_name": "ELLIE",
        "name_prefix": "Ms.",
        "credential": "RDN, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ID",
            "license": "D-626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "erockidid@icloud.com",
            "affiliation": "N",
            "endpointDescription": "5424 n sun shimmer ave, Meridian Id 83646-5536",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5424 N Sun Shimmer Ave",
            "city": "Meridian",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836465536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jacob Robison
• Shawn Robison, PHARMD
• Miranda Robledo Amezcua, MD
• Destini Raeline Marie Robling
• Rock and Armor Physical Therapy and Sports Performance, LLC
• Germaine Roebuck Jr.
• Maria Fernanda Rogel Perez
• Beth S Rogers, MD
• Carissa Marie Rogers, LMSW
• Duke Rogers, RN

• All providers in Meridian, ID
• Registered Dietitian in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.