Active NPI
Barbara Marie Leydecker, RDN
- Registered Dietitian
- Kennesaw, GA
National Provider Identifier
1366131971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD005606
- Practice address
- 290 Kennesaw State University Rd NW
Kennesaw, GA 30144-5590 - Phone
- (470) 578-4364
- NPI assigned
- May 1, 2023
- 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 | LD005606 | GA | Primary |
Addresses
Primary practice location
290 Kennesaw State University Rd NW
Kennesaw, GA 30144-5590
Mailing address
10247 Highway 92 Unit 8-301
Woodstock, GA 30188-3993
Phone (404) 626-9449
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 |
|---|---|---|---|
| LD005606 | GA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682899200000",
"number": "1366131971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10247 HIGHWAY 92 UNIT 8-301",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301883993",
"telephone_number": "404-626-9449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 KENNESAW STATE UNIVERSITY RD NW",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301445590",
"telephone_number": "470-578-4364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEYDECKER",
"first_name": "BARBARA",
"middle_name": "MARIE",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-01",
"last_updated": "2023-05-01",
"certification_date": "2023-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD005606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennesaw, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.