Active NPI
Lisa Van Leeuwen, MS, RDN, LDN
- Registered Dietitian
- Stoneham, MA
National Provider Identifier
1275286338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 11 North St
Stoneham, MA 02180-1040 - Phone
- (760) 625-9708
- NPI assigned
- Jan 30, 2022
- Reactivated
- Jun 13, 2024
- 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 | Primary |
Addresses
Primary practice location
11 North St
Stoneham, MA 02180-1040
Mailing address
11 North St
Stoneham, MA 02180-1040
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718323200000",
"number": "1275286338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 NORTH ST",
"city": "STONEHAM",
"state": "MA",
"postal_code": "021801040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 NORTH ST",
"city": "STONEHAM",
"state": "MA",
"postal_code": "021801040",
"telephone_number": "760-625-9708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN LEEUWEN",
"first_name": "LISA",
"credential": "MS, RDN, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-30",
"last_updated": "2024-06-14",
"certification_date": "2024-06-14",
"deactivation_date": "2022-03-07",
"reactivation_date": "2024-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stoneham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.