Active NPI
Jennifer Nichole Lease, RD, CDN
- Registered Dietitian
- Oceanside, NY
National Provider Identifier
1518491521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86014416
- Practice address
- 253 Merrifield Ave
Oceanside, NY 11572-2911 - Phone
- (516) 425-3637
- NPI assigned
- Apr 17, 2017
- 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 | 86014416 | NY | Primary |
Addresses
Primary practice location
253 Merrifield Ave
Oceanside, NY 11572-2911
Mailing address
253 Merrifield Ave
Oceanside, NY 11572-2911
Phone (516) 425-3637
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86014416 | NY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492387200000",
"number": "1518491521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "253 MERRIFIELD AVE",
"city": "OCEANSIDE",
"state": "NY",
"postal_code": "115722911",
"telephone_number": "516-425-3637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "253 MERRIFIELD AVE",
"city": "OCEANSIDE",
"state": "NY",
"postal_code": "115722911",
"telephone_number": "516-425-3637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEASE",
"first_name": "JENNIFER",
"middle_name": "NICHOLE",
"name_prefix": "Miss",
"credential": "RD, CDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-17",
"last_updated": "2017-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "86014416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oceanside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.