Active NPI
Leslie Conger Davis, RD, LD, CDE
- Registered Dietitian
- Dacula, GA
National Provider Identifier
1336580307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD001208
- Practice address
- 3617 Braselton Hwy
Suite 104
Dacula, GA 30019-4667 - Phone
- (770) 718-6736
- NPI assigned
- Jul 8, 2013
- 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 | LD001208 | GA | Primary |
Addresses
Primary practice location
3617 Braselton Hwy
Suite 104
Dacula, GA 30019-4667
Mailing address
2709 Legislative LN
Buford, GA 30519-8037
Phone (770) 718-6736
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA, OR
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5021 Tualata LN
Lake Oswego, OR 97035-7116
Phone (888) 766-3439
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD001208 | GA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johns Creek Surgery PC | Current | Accepting new patients | |
| Strategic Nutrition | Dietitian, Registered | Current | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Locations
6920 McGinnis Ferry Rd
Ste 340
Suwanee, GA 30024
Phone (770) 232-2911
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 and National Provider Directory roles.
-
- Surgery Physician
- Suwanee, GA
- NPI 1922033802
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403740800000",
"number": "1336580307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2709 LEGISLATIVE LN",
"city": "BUFORD",
"state": "GA",
"postal_code": "305198037",
"telephone_number": "770-718-6736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3617 BRASELTON HWY",
"address_2": "SUITE 104",
"city": "DACULA",
"state": "GA",
"postal_code": "300194667",
"telephone_number": "770-718-6736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "LESLIE",
"middle_name": "CONGER",
"name_prefix": "Mrs.",
"credential": "RD, LD, CDE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-08",
"last_updated": "2014-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD001208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dacula, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.