Active NPI
Elizabeth Warren Wickliffe
- Registered Dietitian
- Germantown, TN
National Provider Identifier
1992560791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LDN0000002650
- Practice address
- 2193 Glenbar Dr
Germantown, TN 38139-5418 - Phone
- (901) 218-9516
- NPI assigned
- Feb 20, 2024
- Last updated
- Feb 20, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | LDN0000002650 | TN | Primary |
Addresses
Primary practice location
2193 Glenbar Dr
Germantown, TN 38139-5418
Mailing address
2193 Glenbar Dr
Germantown, TN 38139-5418
Phone (901) 218-9516
Other names 1
- Beth Wickliffe
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 |
|---|---|---|---|
| LDN0000002650 | TN | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708387200000",
"number": "1992560791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2193 GLENBAR DR",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "381395418",
"telephone_number": "901-218-9516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2193 GLENBAR DR",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "381395418",
"telephone_number": "901-218-9516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WICKLIFFE",
"first_name": "ELIZABETH",
"middle_name": "WARREN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-20",
"last_updated": "2024-02-20",
"certification_date": "2024-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TN",
"license": "LDN0000002650",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BETH",
"last_name": "WICKLIFFE",
"credential": "RDN, LDN",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Germantown, TN
- Kristina Marie Whitten, FNP
- Patience Whitten, DNP, FNP-BC
- Allison Paige Whittle, M.D.
- Wholeheart Women's Christian Counseling Inc.
- Wholeheart Women's Christian Counseling PLLC
- Christen Wiedower, FNP
- Eric R. Wiedower, DO
- Mary Josephine Wiencken, MS, CCC-SLP
- Robert A Wiener, MD
- Mary Beth Wiggins, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.