Active NPI
Leah Rachel Wundrow, RDN
- Registered Dietitian
- Lakeland, FL
National Provider Identifier
1447054747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND8964
- Practice address
- 5135 Highlands Lakeview Loop
Lakeland, FL 33812-5039 - Phone
- (317) 473-5152
- NPI assigned
- Apr 3, 2025
- 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 | ND8964 | FL | Primary |
Addresses
Primary practice location
5135 Highlands Lakeview Loop
Lakeland, FL 33812-5039
Mailing address
5135 Highlands Lakeview Loop
Lakeland, FL 33812-5039
Phone (317) 473-5152
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
19 W 24TH St
FL 4
New York, NY 10010-3239
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND8964 | FL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743638400000",
"number": "1447054747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5135 HIGHLANDS LAKEVIEW LOOP",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338125039",
"telephone_number": "317-473-5152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5135 HIGHLANDS LAKEVIEW LOOP",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338125039",
"telephone_number": "317-473-5152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WUNDROW",
"first_name": "LEAH",
"middle_name": "RACHEL",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-04-03",
"last_updated": "2025-04-03",
"certification_date": "2025-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND8964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; 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.