Individual provider Active NPI

Libby Micaela Moser, MS, RDN, LDN

  • Registered Dietitian
  • Chicago, IL
National Provider Identifier
1760049415
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86088997 Issued in IL
Practice address
1 N State St FL 15
Chicago, IL 60602-3206
Phone
(312) 566-7079
NPI assigned
May 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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 86088997 IL Primary

Addresses

Primary practice location

1 N State St FL 15
Chicago, IL 60602-3206

Mailing address

1 N State St FL 15
Chicago, IL 60602-3206
Phone (312) 566-7079

Other identifiers 1

IdentifierTypeStateIssuer
133V00000XOtherDIETITIAN, REGISTERED

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
86088997ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Piece of Nutrition, LLC Current Accepting new patients
The Renfrew Center of Illinois PastSince Jul 24, 2022 Accepting new patients
The Renfrew Centers, Inc. Past Accepting new patients

Locations

213 W Institute Pl
Ste 210
Chicago, IL 60610
Phone (312) 945-0154

1 N State St
Fl 15
Chicago, IL 60602
Phone (312) 566-7079

Organizations & group practices 3

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": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1760049415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 N STATE ST FL 15",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023206",
            "telephone_number": "312-566-7079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 N STATE ST FL 15",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023206",
            "telephone_number": "312-566-7079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSER",
        "first_name": "LIBBY",
        "middle_name": "MICAELA",
        "credential": "MS, RDN, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-28",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "86088997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIETITIAN, REGISTERED",
            "identifier": "133V00000X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.