OrganizationActive
Evo Body Image, LLC
NPI 1821768649 · Registered Dietitian · Birmingham, MI
Provider details
- NPI number
- 1821768649
- Entity type
- Organization
- Primary specialty
- Registered DietitianDietary & Nutritional Service Providers
- Organization subpart
- No
- Authorized official
- Sidra Elia, Organizer(248) 595-2363
Specialties & taxonomies
Dietary & Nutritional Service Providers
- Clinic/Center261Q00000X
Ambulatory Health Care Facilities
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
950 E Maple Rd Ste L10
Birmingham, MI 48009-6482
Phone: (248) 595-2363
Street-level locationGet directions
Mailing address
6642 Leytonstone Blvd
West Bloomfield, MI 48322-1200
Registry dates
- Enumerated
- 2021-09-14
- Last updated
- 2021-09-14
- Certified
- 2021-09-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.