Individual provider Active NPI

Lacey Julia-Ann Ireton, RD, LD

  • Registered Dietitian
  • Wichita, KS
National Provider Identifier
1558060475
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2208 Issued in KS
Practice address
5500 E Kellogg Dr
Wichita, KS 67218-1607
Phone
(316) 686-2221
NPI assigned
Feb 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2208 KS Primary

Addresses

Primary practice location

5500 E Kellogg Dr
Wichita, KS 67218-1607

Mailing address

1945 S Denene St
Wichita, KS 67209-1974
Phone (316) 993-2046

Other names 1

  • Ms. Lacey Julia-Ann Johnston Former name

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

LicenseStateTypeSpecialty
2208KSMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1558060475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 S DENENE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672091974",
            "telephone_number": "316-993-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 E KELLOGG DR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672181607",
            "telephone_number": "316-686-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRETON",
        "first_name": "LACEY",
        "middle_name": "JULIA-ANN",
        "name_prefix": "Mrs.",
        "credential": "RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-28",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KS",
            "license": "2208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACEY",
            "last_name": "JOHNSTON",
            "middle_name": "JULIA-ANN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; 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.