NPIMap

Organization Active NPI

New Leaf Nutrition LLC

  • Registered Dietitian
  • Glendale, WI
National Provider Identifier
1780118992
Registry record updated Jan 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LDD10150450 Issued in OR
Legal business name
NEW LEAF NUTRITION LLC
Practice address
5261 N Port Washington Rd
Glendale, WI 53217-4903
Phone
(206) 948-8810
NPI assigned
Apr 13, 2017
Last updated
Jan 22, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2018

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

Authorized official

Name
Lindsay KeeneyNPI 1851607113
Title
Rd
Phone
(206) 948-8810

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X LDD10150450 OR Primary

Addresses

Primary practice location

5261 N Port Washington Rd
Glendale, WI 53217-4903

Mailing address

5261 N Port Washington Rd
Glendale, WI 53217-4903
Phone (206) 948-8810

National Provider Directory

National Provider Directory

Locations

5261 N Port Washington Rd
Glendale, WI 53217
Phone (414) 332-6001

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516579200000",
    "number": "1780118992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5261 N PORT WASHINGTON RD",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174903",
            "telephone_number": "206-948-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5261 N PORT WASHINGTON RD",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174903",
            "telephone_number": "206-948-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LEAF NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-13",
        "last_updated": "2018-01-22",
        "status": "A",
        "authorized_official_last_name": "KEENEY",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_title_or_position": "RD",
        "authorized_official_telephone_number": "206-948-8810"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LDD10150450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2018; 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.