Individual provider Active NPI

Leslie Arlene Johnson

  • Registered Dietitian
  • Sandusky, OH
National Provider Identifier
1003540378
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
09820 Issued in OH
Practice address
1221 Hayes Ave
Sandusky, OH 44870-3345
Phone
(419) 557-6990
NPI assigned
Jul 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 09820 OH Primary

Addresses

Primary practice location

1221 Hayes Ave
Sandusky, OH 44870-3345

Mailing address

1111 Hayes Ave
Sandusky, OH 44870-3323
Phone (419) 557-6363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220902002274 OH Practitioner - Registered Dietitian Or Nutrition Professional 5193109593 Reassigns benefits to 1 organization
I20260414000603 AL Practitioner - Registered Dietitian Or Nutrition Professional 5193109593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1108 Oshaughnessy Ave NE
Huntsville, AL 35801-6261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09820OHMDRegistered Dietitian

Practice roles (18 of 20)

OrganizationSpecialtyStatusNew patients
Green Bean Grove LLC Dietitian, Registered Current Accepting new patients
Family Health Services of Erie County CurrentSince Sep 13, 2022 Accepting new patients
Family Health Services of Erie County CurrentSince Sep 13, 2022 Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
XP Sports International Dietitian, Registered Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Firelands Regional Medical Center Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients

Locations

265 Benedict Ave
Norwalk, OH 44857
Phone (419) 219-9776

1912 Hayes Ave
Ste D
Sandusky, OH 44870
Phone (419) 502-4800

Networks

  • TX HMO D-SNP
  • TX HMO

Organizations & group practices 18

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1003540378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 HAYES AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448703323",
            "telephone_number": "419-557-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 HAYES AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448703345",
            "telephone_number": "419-557-6990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LESLIE",
        "middle_name": "ARLENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "09820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.