Organization Active NPI

Dietitian Group Corporation

  • Nutritionist
  • Boca Raton, FL
National Provider Identifier
1093312381
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
Legal business name
DIETITIAN GROUP CORPORATION
Practice address
7440 San Clemente PL
Boca Raton, FL 33433-1005
Phone
(718) 877-4937
NPI assigned
Oct 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Authorized official

Name
Leah LebelNPI 1154756252
Title
Owner
Phone
(718) 877-4937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
NutritionistGroup: 193400000X SINGLE SPECIALTY GROUP 133N00000X Primary

Addresses

Primary practice location

7440 San Clemente PL
Boca Raton, FL 33433-1005

Mailing address

7440 San Clemente PL
Boca Raton, FL 33433-1005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210317000564 FL Part B Supplier - Clinic/Group Practice 7416363452 Receives reassigned benefits from 4 practitioners
Practice locations: Boca Raton, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602115200000",
    "number": "1093312381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7440 SAN CLEMENTE PL",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334331005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7440 SAN CLEMENTE PL",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334331005",
            "telephone_number": "718-877-4937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIETITIAN GROUP CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "LEBEL",
        "authorized_official_first_name": "LEAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-877-4937"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.