Active NPI
Daniel Levine
- Registered Dietitian
- Las Vegas, NV
National Provider Identifier
1528550480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 39402-DI-0
- Practice address
- 4215 S Grand Canyon Dr
Las Vegas, NV 89147-7172 - Phone
- (702) 664-1204
- NPI assigned
- Jun 5, 2018
- Last updated
- Apr 8, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | TL.0011424 | CO | |
| Registered Dietitian | 133V00000X | 39402-DI-0 | NV | Primary |
Addresses
Primary practice location
4215 S Grand Canyon Dr
Las Vegas, NV 89147-7172
Mailing address
12631 E 17TH Ave # B8202
Aurora, CO 80045-2527
Phone (303) 724-7494
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39402-DI-0 | NV | MD | Registered Dietitian |
| TL.0011424 | CO | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrated Health and Wellness Center LLC | Past | Accepting new patients | |
| Food Connection LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Physical Therapist
- Las Vegas, NV
- NPI 1790222362
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775606400000",
"number": "1528550480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12631 E 17TH AVE # B8202",
"city": "AURORA",
"state": "CO",
"postal_code": "800452527",
"telephone_number": "303-724-7494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4215 S GRAND CANYON DR",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891477172",
"telephone_number": "702-664-1204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVINE",
"first_name": "DANIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-05",
"last_updated": "2026-04-08",
"certification_date": "2026-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CO",
"license": "TL.0011424",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NV",
"license": "39402-DI-0",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.