Active NPI
Leonard John Brancewicz, RPH, NMD
- Nutritionist
- Peachtree City, GA
National Provider Identifier
1780029660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- RP028734L
- Practice address
- 1200 Highway 745
Suite 3
Peachtree City, GA 30269 - Phone
- (678) 228-8900
- NPI assigned
- May 6, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Nutritionist | 133N00000X | RP028734L | PA | Primary |
Addresses
Primary practice location
1200 Highway 745
Suite 3
Peachtree City, GA 30269
Mailing address
1200 Highway 745
Suite 3
Peachtree City, GA 30269
Phone (678) 228-8900
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP028734L | PA | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480291200000",
"number": "1780029660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 HIGHWAY 745",
"address_2": "SUITE 3",
"city": "PEACHTREE CITY",
"state": "GA",
"postal_code": "30269",
"telephone_number": "678-228-8900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 HIGHWAY 745",
"address_2": "SUITE 3",
"city": "PEACHTREE CITY",
"state": "GA",
"postal_code": "30269",
"telephone_number": "678-228-8900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANCEWICZ",
"first_name": "LEONARD",
"middle_name": "JOHN",
"credential": "RPH, NMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-06",
"last_updated": "2016-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "PA",
"license": "RP028734L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peachtree City, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.