Individual provider Active NPI

Alexandra Leibold, MS, RD, LD

  • Registered Dietitian
  • Dallas, TX
National Provider Identifier
1609469519
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT86554 Issued in TX
Practice address
14651 Dallas Pkwy Ste 134
Dallas, TX 75254-8904
Phone
(317) 441-1333
NPI assigned
Feb 11, 2021
Last updated
Feb 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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 DT86554 TX Primary

Addresses

Primary practice location

14651 Dallas Pkwy Ste 134
Dallas, TX 75254-8904

Mailing address

14651 Dallas Pkwy Ste 134
Dallas, TX 75254-8904
Phone (317) 441-1333

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DT86554TXMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1609469519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14651 DALLAS PKWY STE 134",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752548904",
            "telephone_number": "317-441-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14651 DALLAS PKWY STE 134",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752548904",
            "telephone_number": "317-441-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBOLD",
        "first_name": "ALEXANDRA",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT86554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; 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.