Active NPI
Leslie Ann Bullock, MOE, RD
- Registered Dietitian
- Manchester, NH
National Provider Identifier
1346511078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 173
- Practice address
- 195 McGregor St Ste 312
Manchester, NH 03102-3749 - Phone
- (603) 663-6297
- Fax
- (603) 663-6735
- NPI assigned
- Jan 26, 2012
- 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 | 173 | NH | Primary |
Addresses
Primary practice location
195 McGregor St Ste 312
Manchester, NH 03102-3749
Mailing address
195 McGregor St Ste 312
Manchester, NH 03102-3749
Phone (603) 663-6297
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 173 | NH | MD | Intellectual & Developmental Disabilities Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327536000000",
"number": "1346511078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "195 MCGREGOR ST STE 312",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031023749",
"telephone_number": "603-663-6297",
"fax_number": "603-663-6735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "195 MCGREGOR ST STE 312",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031023749",
"telephone_number": "603-663-6297",
"fax_number": "603-663-6735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULLOCK",
"first_name": "LESLIE",
"middle_name": "ANN",
"credential": "MOE, RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-26",
"last_updated": "2012-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NH",
"license": "173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.