Individual provider Active NPI

Lellieth Keize, REGISTERED DIETITIAN

  • Registered Dietitian
  • Darien, CT
National Provider Identifier
1043582026
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
965780 Issued in CT
Practice address
19 Old Kings Hwy S Ste 200
Darien, CT 06820-4532
Phone
(203) 952-3534
Fax
(203) 803-4697
NPI assigned
Feb 6, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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 965780 CT Primary

Addresses

Primary practice location

19 Old Kings Hwy S Ste 200
Darien, CT 06820-4532

Mailing address

14 Ferris Ave Apt 10
Norwalk, CT 06854-1538
Phone (203) 952-9715

Other practice location 1

173 Huguenot St Ste 200
New Rochelle, NY 10801-7710
Phone (203) 952-3534

Other names 1

  • Mrs. Lellieth Latchman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180504001367 NY Practitioner - Registered Dietitian Or Nutrition Professional 4587928296 Practice locations: New Rochelle, NY
I20200403001048 CT Practitioner - Registered Dietitian Or Nutrition Professional 4587928296 Reassigns benefits to 1 organization
Practice locations: Norwalk, CT

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

101 Merritt
7 Suite 300
Norwalk, CT 06851-1059
Phone (203) 952-9715

173 Huguenot St
Suite 200
New Rochelle, NY 10801-7710
Phone (203) 952-3534

Hospital & facility affiliations

  • Norwalk Hospital Hospital, Norwalk, CT, CCN 070034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007376NYMDMental Health Counselor
965780CTMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Norwalk Hospital Association CurrentSince Mar 15, 2020 Accepting new patients
Norwalk Hospital Association CurrentSince Mar 15, 2020 Accepting new patients
Holistic Elevation LLC Current Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Locations

520 West Ave
Norwalk, CT 06850
Phone (203) 852-2417

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1328486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1043582026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 FERRIS AVE APT 10",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068541538",
            "telephone_number": "203-952-9715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 OLD KINGS HWY S STE 200",
            "city": "DARIEN",
            "state": "CT",
            "postal_code": "068204532",
            "telephone_number": "203-952-3534",
            "fax_number": "203-803-4697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "173 Huguenot St Ste 200",
            "address_purpose": "LOCATION",
            "city": "New Rochelle",
            "state": "NY",
            "postal_code": "108017710",
            "country_code": "US",
            "telephone_number": "203-952-3534",
            "fax_number": "203-803-4697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEIZE",
        "first_name": "LELLIETH",
        "name_prefix": "Ms.",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-06",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "965780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LELLIETH",
            "last_name": "LATCHMAN",
            "prefix": "MRS.",
            "credential": "MS, RDN, CDCES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Darien, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; 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.