Individual provider Active NPI

Gisele Leger - Leblanc, MS RD LDN CNSD

  • Registered Dietitian
  • Worcester, MA
National Provider Identifier
1669790648
Registry record updated May 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2341 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(774) 441-6280
Fax
(774) 443-3983
NPI assigned
May 14, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2010

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 2341 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

48 Rocky Woods Rd
Hopkinton, MA 01748-1064
Phone (508) 686-3114

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
2341MAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273795200000",
    "number": "1669790648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 ROCKY WOODS RD",
            "city": "HOPKINTON",
            "state": "MA",
            "postal_code": "017481064",
            "telephone_number": "508-686-3114",
            "fax_number": "508-686-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "774-441-6280",
            "fax_number": "774-443-3983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGER - LEBLANC",
        "first_name": "GISELE",
        "credential": "MS RD LDN CNSD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-14",
        "last_updated": "2010-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "2341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2010; 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.