Leigh B Pickard, MS, RD, LD
Individual provider Active NPI Registered Dietitian · Jackson, MS
NPI 1720121627 · NPPES record last updated Jan 22, 2020
Key facts
- NPI
- 1720121627
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- D1161 (MS)
- Practice address
- 1850 Chadwick Dr
Jackson, MS 39204-3404 - Phone
- (601) 373-1793
- Fax
- (601) 376-1466
- NPI assigned
- Feb 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clarksdale Hma LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | D1161 | MS | Yes |
Addresses
Primary practice location
1850 Chadwick Dr
Jackson, MS 39204-3404
Mailing address
785 Ohio Ave
Suite 2F
Clarksdale, MS 38614-6217
Phone (662) 621-5081
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720121627 | Medicaid | MS |
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- Anne D Piazza
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- Emily Pickich
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All providers in Jackson, MS · Registered Dietitian in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.