Active NPI
Carrie Mathews Leonard, RD
- Registered Dietitian
- Coos Bay, OR
National Provider Identifier
1518782739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D-10204735
- Practice address
- 1775 Thompson Rd
Coos Bay, OR 97420-2198 - Phone
- (541) 269-8182
- NPI assigned
- Nov 21, 2024
- Last updated
- Nov 21, 2024
- 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 | D-10204735 | OR | Primary |
Addresses
Primary practice location
1775 Thompson Rd
Coos Bay, OR 97420-2198
Mailing address
PO Box 1432
Winchester Bay, OR 97467-0820
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
| License | State | Type | Specialty |
|---|---|---|---|
| D-10204735 | OR | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732147200000",
"number": "1518782739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1432",
"city": "WINCHESTER BAY",
"state": "OR",
"postal_code": "974670820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1775 THOMPSON RD",
"city": "COOS BAY",
"state": "OR",
"postal_code": "974202198",
"telephone_number": "541-269-8182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHEWS LEONARD",
"first_name": "CARRIE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-21",
"last_updated": "2024-11-21",
"certification_date": "2024-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": "D-10204735",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coos Bay, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.