Active NPI
Emily Grace Labombard, MPH, RDN, LDN
- Registered Dietitian
- Colorado Springs, CO
National Provider Identifier
1063139764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 5672
- Practice address
- 6156 Rockville Dr
Colorado Springs, CO 80923-3806 - Phone
- (719) 684-5754
- NPI assigned
- Oct 24, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 5672 | MA | Primary |
Addresses
Primary practice location
6156 Rockville Dr
Colorado Springs, CO 80923-3806
Mailing address
26 Worcester St Apt 202
Boston, MA 02118-3376
Phone (978) 877-9548
Other practice location 1
26 Worcester St Apt 202
Boston, MA 02118-3376
Phone (978) 877-9548
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5672 | MA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Performance Nutrition LLC | Dietitian, Registered | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Registered Dietitian
- Colorado Springs, CO
- NPI 1003370115
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666569600000",
"number": "1063139764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 WORCESTER ST APT 202",
"city": "BOSTON",
"state": "MA",
"postal_code": "021183376",
"telephone_number": "978-877-9548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6156 ROCKVILLE DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809233806",
"telephone_number": "719-684-5754"
}
],
"practiceLocations": [
{
"address_1": "26 Worcester St Apt 202",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021183376",
"country_code": "US",
"telephone_number": "978-877-9548",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LABOMBARD",
"first_name": "EMILY",
"middle_name": "GRACE",
"credential": "MPH, RDN, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-24",
"last_updated": "2022-10-24",
"certification_date": "2022-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "5672",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.