Active NPI
Eileen Richards Deleeuw, MS,RD,CDE
- Registered Dietitian
- Tooele, UT
National Provider Identifier
1104056068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 104266-4901
- Practice address
- 300 South Main Street #3
Tooele, UT 84074 - Phone
- (435) 843-8881
- NPI assigned
- Jul 24, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | 104266-4901 | UT | Primary |
Addresses
Primary practice location
300 South Main Street #3
Tooele, UT 84074
Mailing address
222 Julie Ann Court
Tooele, UT 84074
Phone (435) 840-0299
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104266-4901 | UT | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Practice Medical Clinic, LLC | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/16023/brand/1/csg/1/fhir/r4
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.
-
- Primary Care Clinic/Center
- Tooele, UT
- NPI 1548302268
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248393600000",
"number": "1104056068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 JULIE ANN COURT",
"city": "TOOELE",
"state": "UT",
"postal_code": "84074",
"telephone_number": "435-840-0299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 SOUTH MAIN STREET #3",
"city": "TOOELE",
"state": "UT",
"postal_code": "84074",
"telephone_number": "435-843-8881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELEEUW",
"first_name": "EILEEN",
"middle_name": "RICHARDS",
"credential": "MS,RD,CDE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-24",
"last_updated": "2009-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "UT",
"license": "104266-4901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tooele, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.