Individual provider Active NPI

Leyla Mumin, RD

  • Registered Dietitian
  • Saint Cloud, MN
National Provider Identifier
1457712507
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
4545 Issued in MN
Practice address
5211 Grouse CT
Saint Cloud, MN 56303-4676
Phone
(303) 570-8578
NPI assigned
Mar 17, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X
Registered Dietitian 133V00000X MN
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 4545 MN Primary

Addresses

Primary practice location

5211 Grouse CT
Saint Cloud, MN 56303-4676

Mailing address

5211 Grouse CT
Saint Cloud, MN 56303-4676
Phone (303) 570-8578

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

LicenseStateTypeSpecialty
4545MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Achieved Goals, LLC Dietitian, Registered CurrentSince Feb 18, 2024 Accepting new patients

Organizations & group practices 1

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": "1458172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1457712507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5211 GROUSE CT",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034676",
            "telephone_number": "303-570-8578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5211 GROUSE CT",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034676",
            "telephone_number": "303-570-8578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMIN",
        "first_name": "LEYLA",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-17",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "4545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.