Individual provider Active NPI

Lauren Iacobucci

  • Registered Dietitian
  • Highland Village, TX
National Provider Identifier
1225503402
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT91934 Issued in TX
Practice address
916 Lochmoor LN
Highland Village, TX 75077-3119
Phone
(401) 473-4581
NPI assigned
Oct 3, 2018
Last updated
Apr 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DT91934 TX Primary
Registered Dietitian 133V00000X LDN01331 RI

Addresses

Primary practice location

916 Lochmoor LN
Highland Village, TX 75077-3119

Mailing address

1538 Glenmore Dr
Lewisville, TX 75077-2417

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

State licenses

LicenseStateTypeSpecialty
LDN01331RIMDRegistered Dietitian
DT91934TXMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital CurrentSince Nov 29, 2023 Accepting new patients
Rhode Island Hospital Dietitian, Registered CurrentSince Nov 29, 2023 Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Locations

593 Eddy St
Providence, RI 02903

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

Organizations & group practices 3

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": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1225503402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1538 GLENMORE DR",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750772417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 LOCHMOOR LN",
            "city": "HIGHLAND VILLAGE",
            "state": "TX",
            "postal_code": "750773119",
            "telephone_number": "401-473-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IACOBUCCI",
        "first_name": "LAUREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT91934",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "RI",
            "license": "LDN01331",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Village, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.