Individual provider Active NPI

Leigh J Willingham, R.D.

  • Registered Dietitian
  • Gulf Breeze, FL
National Provider Identifier
1033356258
Registry record updated Jan 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND 4164 Issued in FL
Practice address
1579 Kitty Hawk Dr
Gulf Breeze, FL 32563-8405
Phone
(850) 934-6626
NPI assigned
Jan 9, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X ND 4164 FL Primary
Renal Nutrition Registered Dietitian 133VN1005X ND 4164 FL
Metabolic Nutrition Registered Dietitian 133VN1006X ND 4164 FL

Addresses

Primary practice location

1579 Kitty Hawk Dr
Gulf Breeze, FL 32563-8405

Mailing address

1579 Kitty Hawk Dr
Gulf Breeze, FL 32563-8405
Phone (850) 934-6626

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

LicenseStateTypeSpecialty
ND 4164FLMDRenal Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231459200000",
    "number": "1033356258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1579 KITTY HAWK DR",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325638405",
            "telephone_number": "850-934-6626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1579 KITTY HAWK DR",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325638405",
            "telephone_number": "850-934-6626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLINGHAM",
        "first_name": "LEIGH",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "R.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-09",
        "last_updated": "2009-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND 4164",
            "primary": true
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "FL",
            "license": "ND 4164",
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "FL",
            "license": "ND 4164",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.