Active NPI
Angie Ison, MS, RDN, LRD, CLC
- Registered Dietitian
- Fort Leonard Wood, MO
National Provider Identifier
1477803617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1564
- Practice address
- 4234 Illinois Ave
Fort Leonard Wood, MO 65473-9098 - Phone
- (573) 596-1762
- NPI assigned
- Sep 14, 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 | 1564 | ND | Primary |
Addresses
Primary practice location
4234 Illinois Ave
Fort Leonard Wood, MO 65473-9098
Mailing address
4234 Illinois Ave
Fort Leonard Wood, MO 65473-9098
Phone (573) 596-1762
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1564 | ND | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778112000000",
"number": "1477803617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4234 ILLINOIS AVE",
"city": "FORT LEONARD WOOD",
"state": "MO",
"postal_code": "654739098",
"telephone_number": "573-596-1762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4234 ILLINOIS AVE",
"city": "FORT LEONARD WOOD",
"state": "MO",
"postal_code": "654739098",
"telephone_number": "573-596-1762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISON",
"first_name": "ANGIE",
"credential": "MS, RDN, LRD, CLC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-14",
"last_updated": "2026-05-07",
"certification_date": "2026-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ND",
"license": "1564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Leonard Wood, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.