Rd of Nepa LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

RD OF NEPA LLC

Practice address

532 Main St Ste 3
Moosic, PA 18507-1001

Phone

(570) 457-2464

Fax

(570) 457-2492

NPI assigned

Aug 27, 2018

Organization subpart

No

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

Authorized official

Name

Leanna Tabatabaie, MS, RDNNPI 1457854150

Title

Owner

Phone

(570) 457-2464

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leanna Tabatabaie, MS, RDN, LDN

  • Registered Dietitian
  • Moosic, PA
  • NPI 1457854150
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662595200000",
    "number": "1821579913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 MAIN ST STE 3",
            "city": "MOOSIC",
            "state": "PA",
            "postal_code": "185071001",
            "telephone_number": "570-457-2464",
            "fax_number": "570-457-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 MAIN ST STE 3",
            "city": "MOOSIC",
            "state": "PA",
            "postal_code": "185071001",
            "telephone_number": "570-457-2464",
            "fax_number": "570-457-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RD OF NEPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-27",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A",
        "authorized_official_last_name": "TABATABAIE",
        "authorized_official_first_name": "LEANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-457-2464",
        "authorized_official_credential": "MS, RDN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn Marie Pons, LCSW
• Brian Porcelli, LSW
• Melanie Alexis Priebe, PA-C
• Quaser Amin, M.D., PC
• Jenna Marie Quinn, AUD
• Realm Chiropractic, LLC
• Residential Healthcare of NE PA, LLC
• Residential Healthcare of NE PA, LLC
• Michael D. Revilak, PHARMD
• Colleen Flynn Ries, PMHNP-BC

• Clinic/Center in Moosic, PA
• Providers in Moosic, PA by specialty
• Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.