Active NPI
Alexandra Lewis, MS, RD, LD/N
- Registered Dietitian
- Ponte Vedra, FL
National Provider Identifier
1760748115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND6225
- Practice address
- 74 Forestview LN
Ponte Vedra, FL 32081-0043 - Phone
- (904) 625-5357
- NPI assigned
- Apr 10, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | ND6225 | FL | Primary |
Addresses
Primary practice location
74 Forestview LN
Ponte Vedra, FL 32081-0043
Mailing address
74 Forestview LN
Ponte Vedra, FL 32081-0043
Phone (904) 625-5357
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
| License | State | Type | Specialty |
|---|---|---|---|
| ND6225 | FL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | 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": "1334016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710460800000",
"number": "1760748115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74 FORESTVIEW LN",
"city": "PONTE VEDRA",
"state": "FL",
"postal_code": "320810043",
"telephone_number": "904-625-5357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74 FORESTVIEW LN",
"city": "PONTE VEDRA",
"state": "FL",
"postal_code": "320810043",
"telephone_number": "904-625-5357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "ALEXANDRA",
"credential": "MS, RD, LD/N",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-10",
"last_updated": "2024-03-15",
"certification_date": "2024-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND6225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponte Vedra, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.