Individual provider Active NPI

Lauren Kolesa, RD

  • Registered Dietitian
  • Randolph, NJ
National Provider Identifier
1447261979
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
872855 Issued in NJ
Practice address
6 Iron Forge LN
Randolph, NJ 07869-4547
Phone
(973) 366-4018
Fax
(973) 366-4018
NPI assigned
Aug 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 872855 NJ Primary

Addresses

Primary practice location

6 Iron Forge LN
Randolph, NJ 07869-4547

Mailing address

6 Iron Forge LN
Randolph, NJ 07869-4547
Phone (973) 366-4018

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)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447261979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 IRON FORGE LN",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078694547",
            "telephone_number": "973-366-4018",
            "fax_number": "973-366-4018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 IRON FORGE LN",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078694547",
            "telephone_number": "973-366-4018",
            "fax_number": "973-366-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLESA",
        "first_name": "LAUREN",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NJ",
            "license": "872855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.