Active NPI
Lesley Nicole Lilly, MS, RDN, LD, IFNCP
- Registered Dietitian
- San Antonio, TX
National Provider Identifier
1134991185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT85977
- Practice address
- 109 E Ridgewood CT # 109
San Antonio, TX 78212-2341 - Phone
- (210) 722-6929
- NPI assigned
- Oct 24, 2023
- Last updated
- Dec 25, 2023
- 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 | DT85977 | TX | Primary |
Addresses
Primary practice location
109 E Ridgewood CT # 109
San Antonio, TX 78212-2341
Mailing address
109 E Ridgewood CT # 109
San Antonio, TX 78212-2341
Phone (210) 722-6929
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT85977 | TX | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703462400000",
"number": "1134991185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 E RIDGEWOOD CT # 109",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782122341",
"telephone_number": "210-722-6929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 E RIDGEWOOD CT # 109",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782122341",
"telephone_number": "210-722-6929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILLY",
"first_name": "LESLEY",
"middle_name": "NICOLE",
"credential": "MS, RDN, LD, IFNCP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-24",
"last_updated": "2023-12-25",
"certification_date": "2023-12-25",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT85977",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.