NPIMap

Organization Active NPI

New Leaf Nutrition

  • Registered Dietitian
  • O'Fallon, MO
National Provider Identifier
1497362180
Registry record updated Sep 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
NEW LEAF NUTRITION
Practice address
18 W Industrial Dr
O Fallon, MO 63366-1926
Phone
(314) 626-3472
NPI assigned
Sep 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2020

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

Authorized official

Name
Jennifer Lyman, RDNPI 1215320031
Title
Owner
Phone
(314) 322-8407

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

18 W Industrial Dr
O Fallon, MO 63366-1926

Mailing address

72 Freymuth Rd
Lake Saint Louis, MO 63367-1906
Phone (314) 322-8407

National Provider Directory

National Provider Directory

Locations

18 W Industrial Dr
O Fallon, MO 63366
Phone (314) 626-3472

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1601078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601078400000",
    "number": "1497362180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 FREYMUTH RD",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633671906",
            "telephone_number": "314-322-8407",
            "fax_number": "314-499-9076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 W INDUSTRIAL DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633661926",
            "telephone_number": "314-626-3472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LEAF NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-26",
        "last_updated": "2020-09-26",
        "certification_date": "2020-09-26",
        "status": "A",
        "authorized_official_last_name": "LYMAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-322-8407",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2020; 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.