Organization Active NPI

Green Bean Grove LLC

  • Registered Dietitian
  • Huntsville, AL
National Provider Identifier
1114884673
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
GREEN BEAN GROVE LLC
Practice address
1108 Oshaughnessy Ave NE
Huntsville, AL 35801-6261
Phone
(256) 213-1702
NPI assigned
Jan 7, 2026
Last updated
Jan 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Authorized official

Name
Leslie Johnson, RDNPI 1003540378
Title
Registered Dietitian
Phone
(256) 679-4764

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
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

1108 Oshaughnessy Ave NE
Huntsville, AL 35801-6261

Mailing address

1108 Oshaughnessy Ave NE
Huntsville, AL 35801-6261
Phone (256) 213-1702

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260414000509 AL Part B Supplier - Clinic/Group Practice 9638644008 Receives reassigned benefits from 1 practitioner
Practice locations: Huntsville, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1767744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767744000000",
    "number": "1114884673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 OSHAUGHNESSY AVE NE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016261",
            "telephone_number": "256-213-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 OSHAUGHNESSY AVE NE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016261",
            "telephone_number": "256-213-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN BEAN GROVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-07",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "256-679-4764",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2026; 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.