Individual provider Active NPI

Alison A Lea, R.D.

  • Registered Dietitian
  • St Louis Park, MN
National Provider Identifier
1902012784
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2399 Issued in MN
Practice address
6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone
(952) 993-2479
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2399 MN Primary

Addresses

Primary practice location

6500 Excelsior Blvd
St Louis Park, MN 55426-4702

Mailing address

6465 Wayzata Blvd
Ste 315
St Louis Park, MN 55426-1728

Other names 1

  • Alison A Moran Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071010000309 MN Practitioner - Registered Dietitian Or Nutrition Professional 2365538121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2399MNMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Aug 21, 2017 Accepting new patients
Park Nicollet Clinic CurrentSince Aug 21, 2017 Accepting new patients

Locations

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246

Organizations & group practices 2

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": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902012784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 WAYZATA BLVD",
            "address_2": "STE 315",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554261728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 EXCELSIOR BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264702",
            "telephone_number": "952-993-2479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEA",
        "first_name": "ALISON",
        "middle_name": "A",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "2399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALISON",
            "last_name": "MORAN",
            "middle_name": "A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.