Jennifer Jaylene Leedom, R.D. , C.D.E.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

1501 N Campbell Ave
Support Services, Room 0430
Tucson, AZ 85724-0001

Phone

(520) 694-0116

NPI assigned

Mar 9, 2009

Last updated

Sep 13, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1225279029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AVE",
            "address_2": "SUPPORT SERVICES PO BOX 245088, ROOM 0430",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857240001",
            "telephone_number": "520-694-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AVE",
            "address_2": "SUPPORT SERVICES, ROOM 0430",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857240001",
            "telephone_number": "520-694-0116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2380 N Ferguson Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857122837",
            "country_code": "US",
            "telephone_number": "520-324-1010",
            "fax_number": "520-324-0029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEEDOM",
        "first_name": "JENNIFER",
        "middle_name": "JAYLENE",
        "name_prefix": "Mrs.",
        "credential": "R.D. ,  C.D.E.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-09",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "419943",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Lee, PHARMD
• Vicki S Lee, OTR
• Yeo Lee, D.O.
• Young Ah Lee, MD
• Young Joo Lee, DDS
• Kevin John Leehey, MD
• Cheryl Ann Leeper, M.S., CCC-A
• Adena B. Lees, LCSW,LISAC,BCETS
• Craig J Lees, LMSW LISAC
• Marcelle D Leet, M.D.

• Registered Dietitian in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Registered Dietitian in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.