Active NPI
Lisa M Coleman, RD LD
- Registered Dietitian
- Waterloo, IA
National Provider Identifier
1639166390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 01585
- Practice address
- 2710 Saint Francis Dr
Suite 510
Waterloo, IA 50702-5619 - Phone
- (319) 272-5358
- Fax
- (319) 272-5445
- NPI assigned
- Sep 28, 2005
- Sex
- Female
- Sole proprietor
- No
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 | 01585 | IA | Primary |
Addresses
Primary practice location
2710 Saint Francis Dr
Suite 510
Waterloo, IA 50702-5619
Mailing address
2710 Saint Francis Dr
Suite 510
Waterloo, IA 50702-5619
Phone (319) 272-5358
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01585 | IA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478649600000",
"number": "1639166390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2710 SAINT FRANCIS DR",
"address_2": "SUITE 510",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507025619",
"telephone_number": "319-272-5358",
"fax_number": "319-272-5445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2710 SAINT FRANCIS DR",
"address_2": "SUITE 510",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507025619",
"telephone_number": "319-272-5358",
"fax_number": "319-272-5445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "LISA",
"middle_name": "M",
"credential": "RD LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-28",
"last_updated": "2016-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IA",
"license": "01585",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.