Kelly Sue Leonard, NUTRITIONIST

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

License

969608 Issued in VA

Practice address

2801 Blue Ridge Rd
Raleigh, NC 27607-0114

Phone

(984) 974-0502

Fax

(984) 974-9579

NPI assigned

Jan 26, 2011

Last updated

Apr 4, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1912202722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 BLUE RIDGE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276070114",
            "telephone_number": "984-974-0502",
            "fax_number": "984-974-9579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 BLUE RIDGE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276070114",
            "telephone_number": "984-974-0502",
            "fax_number": "984-974-9579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "KELLY",
        "middle_name": "SUE",
        "credential": "NUTRITIONIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-26",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "VA",
            "license": "969608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004909976",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leon Byrum Opticians Inc
• Amy Leon
• Alicia Leonard
• Charlotte Randolph Leonard, MS CCCA
• Christina Rae Leonard, NP
• Robin C Leonard
• Sara E. Leonard, MSW, LCSW
• Susan Elizabeth Leonard, PH.D.
• Leone Star Home
• Hock Leong, P.T.

• Pediatric Nutrition Registered Dietitian in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Pediatric Nutrition Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2025; 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.