Individual provider Active NPI

Leslie Gaillard, RD

  • Registered Dietitian
  • Raleigh, NC
National Provider Identifier
1720243074
Registry record updated Dec 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L003806 Issued in NC
Practice address
156 Mine Lake CT
Raleigh, NC 27615-6417
Phone
(415) 606-7407
Fax
(919) 800-3641
NPI assigned
Jul 25, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2015

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 L003806 NC Primary

Addresses

Primary practice location

156 Mine Lake CT
Raleigh, NC 27615-6417

Mailing address

10300 Rocky Ford CT
Raleigh, NC 27614-8907
Phone (415) 606-7407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100719000072 NC Practitioner - Registered Dietitian Or Nutrition Professional 9234261868 Practice locations: Raleigh, NC

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
University of North Carolina at Chapel Hill School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

156 Mine Lake CT
Suite 100
Raleigh, NC 27615-6417
Phone (919) 508-6107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Leslie Gaillard Dietitian, Registered Current Accepting new patients

Organizations & group practices 1

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": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1720243074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 ROCKY FORD CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148907",
            "telephone_number": "415-606-7407",
            "fax_number": "919-800-3641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 MINE LAKE CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276156417",
            "telephone_number": "415-606-7407",
            "fax_number": "919-800-3641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAILLARD",
        "first_name": "LESLIE",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-25",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L003806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.