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Active NPI 1780463059 Individual Practitioner Female Practitioner

Anick Diessongo

Dietitian, Registered • Scott Air Force Base, IL

Professional Overview & Biography Verified Profile Summary

Anick Diessongo is a registered healthcare professional specializing in Dietitian, Registered in Scott Air Force Base, IL. Practice services are available at 4711 THOMAS JEFFERSON CIR APT A under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4711 Thomas Jefferson Cir Apt A

Scott Air Force Base, IL 622256225

Telephone 6462885143

Specialty Benchmarks & Practice Insights

Comparative analytics for Dietitian, Registered in Scott Air Force Base, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 16.7 Yrs
Regional Practice Density
2 Specialists

Practicing in Scott Air Force Base, IL (2895 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-09-26
Dietitian, Registered Primary Specialty

NUCC Taxonomy Code: 133V00000X

State License IL 164009254

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active September 26, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location September 26, 2023

Registered at 4711 THOMAS JEFFERSON CIR APT A, SCOTT AIR FORCE BASE, IL 622256225 (Tel: 6462885143)

📍
Updated Business Mailing Address September 26, 2023

Registered at 19310 WILDCAT TRL, DAVIDSON, NC 280368882

👤
Provider Name / Credentials Updated September 26, 2023

Recorded as ANICK DIESSONGO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 26, 2023

Dietitian, Registered (License #164009254 in IL)

🟢
Initial NPI Registration & Enumeration September 26, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1780463059
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 26, 2023
Last Update: September 26, 2023
Sole Proprietor: No

Mailing Address

19310 Wildcat Trl

Davidson, NC 280368882

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.