Individual provider Active NPI

Leticia Gabriela Renkart, RD

  • Registered Dietitian
  • Lyndhurst, NJ
National Provider Identifier
1578156246
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86197858 Issued in NJ
Practice address
576 Valley Brook Ave Ste M1
Lyndhurst, NJ 07071-1919
Phone
(646) 389-9196
NPI assigned
Feb 14, 2021
Last updated
Nov 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86197858 NJ Primary
Metabolic Nutrition Registered Dietitian 133VN1006X 86197858 NJ
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X 86197858 NJ

Addresses

Primary practice location

576 Valley Brook Ave Ste M1
Lyndhurst, NJ 07071-1919

Mailing address

113 Rutherford PL
North Arlington, NJ 07031-6303
Phone (646) 389-9196

Other practice location 1

113 Rutherford Pl
North Arlington, NJ 07031-6303
Phone (646) 389-9196

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
86197858NJMDObesity and Weight Management Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
The Nutrition Sisters LLC Dietitian, Registered CurrentSince Feb 1, 2021 Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Locations

576 Valley Brook Ave
Ste M1
Lyndhurst, NJ 07071
Phone (646) 389-9196

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.

NPI Registry JSON

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

{
    "created_epoch": "1613260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1578156246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 RUTHERFORD PL",
            "city": "NORTH ARLINGTON",
            "state": "NJ",
            "postal_code": "070316303",
            "telephone_number": "646-389-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 VALLEY BROOK AVE STE M1",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070711919",
            "telephone_number": "646-389-9196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "113 Rutherford Pl",
            "address_purpose": "LOCATION",
            "city": "North Arlington",
            "state": "NJ",
            "postal_code": "070316303",
            "country_code": "US",
            "telephone_number": "646-389-9196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENKART",
        "first_name": "LETICIA",
        "middle_name": "GABRIELA",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-14",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NJ",
            "license": "86197858",
            "primary": true
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "NJ",
            "license": "86197858",
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "NJ",
            "license": "86197858",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyndhurst, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.

Verify at the official NPI Registry.