Basic Information
Provider Information
NPI: 1558747469
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHOTT
FirstName: CHELSEA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 90 JACKSON PIKE
Address2:  
City: GALLIPOLIS
State: OH
PostalCode: 456311560
CountryCode: US
TelephoneNumber: 7404411949
FaxNumber: 7404465982
Practice Location
Address1: 1051 4TH AVENUE
Address2:  
City: GALLIPOLIS
State: OH
PostalCode: 456311560
CountryCode: US
TelephoneNumber: 7404413322
FaxNumber: 7404413379
Other Information
ProviderEnumerationDate: 08/03/2015
LastUpdateDate: 11/25/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/25/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
133V00000XLD.7568OHY Dietary & Nutritional Service ProvidersDietitian, Registered 

No ID Information.


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