Active NPI
Leellen Marie Velasco, RD
- Registered Dietitian
- Tallahassee, FL
National Provider Identifier
1598587628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 13721
- Practice address
- 2350 Phillips Rd
Tallahassee, FL 32308-5346 - Phone
- (636) 524-2661
- NPI assigned
- Oct 29, 2024
- 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 | 13721 | FL | Primary |
Addresses
Primary practice location
2350 Phillips Rd
Tallahassee, FL 32308-5346
Mailing address
2350 Phillips Rd Apt 9310
Tallahassee, FL 32308-5455
Phone (636) 524-2661
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 |
|---|---|---|---|
| 13721 | FL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Vital Nutrition Dietitian | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730160000000",
"number": "1598587628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2350 PHILLIPS RD APT 9310",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323085455",
"telephone_number": "636-524-2661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2350 PHILLIPS RD",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323085346",
"telephone_number": "636-524-2661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VELASCO",
"first_name": "LEELLEN",
"middle_name": "MARIE",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-29",
"last_updated": "2024-10-29",
"certification_date": "2024-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "13721",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.