Kendall Rose McLeod, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

01086433 Issued in MI

Practice address

17400 W 13 Mile Rd
Beverly Hills, MI 48025-5439

Phone

(248) 712-4120

NPI assigned

Nov 7, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kendall Rose McLeod Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment NPD

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1730433178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17400 W 13 MILE RD",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255439",
            "telephone_number": "248-712-4120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44199 Dequindre Rd Ste 415",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851128",
            "country_code": "US",
            "telephone_number": "248-964-5129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4986 Adams Road",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MI",
            "postal_code": "48306",
            "country_code": "US",
            "telephone_number": "248-475-4792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "KENDALL",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-07",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "01086433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klalko104707@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "44199 Dequindre Rd Ste 415",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480851128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klalko104707@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "17400 W 13 Mile Rd",
            "city": "Beverly Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480255439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KENDALL",
            "last_name": "MCLEOD",
            "middle_name": "ROSE",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sienna Marie Mazzola, MA, CCC-SLP
• Ingrid McIntyre, LMSW
• Norman McIntyre, LMSW
• Nancy Louise McKendrick, APRN BC
• Kelly McLaughlin, MSW
• Medical Lane LLC
• Medical Village Optical Shoppe Inc
• Medical Village Optical Shoppe Inc.
• Metro Medical & Manual Therapies LLC
• Michael Pochron, MD,PC

• Registered Dietitian in Beverly Hills, MI
• Providers in Beverly Hills, MI by specialty
• Registered Dietitian in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.