Individual provider Active NPI

Kailee L Leverso, MS, RD, CDE, CD

  • Registered Dietitian
  • Florence, KY
National Provider Identifier
1932540317
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
288658 Issued in KY
Practice address
4900 Houston Rd
Florence, KY 41042-4824
Phone
(859) 212-4625
Fax
(859) 212-4638
NPI assigned
Jul 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DI 60373150 WA
Registered Dietitian 133V00000X 288658 KY Primary

Addresses

Primary practice location

4900 Houston Rd
Florence, KY 41042-4824

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 212-4625

Other names 1

  • Kailee L Farnum Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240117004844 KY Practitioner - Registered Dietitian Or Nutrition Professional 6800039546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DI 60373150WAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Jan 8, 2024 Accepting new patients
Summit Medical Group, Inc Dietitian, Registered CurrentSince Jan 8, 2024 Accepting new patients
Nystrom & Associates, LTD PastSince May 4, 2013 Accepting new patients

Locations

4900 Houston Rd
Florence, KY 41042
Phone (859) 212-5200

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Organizations & group practices 3

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": "1373587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1932540317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-212-4625",
            "fax_number": "859-212-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 HOUSTON RD",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410424824",
            "telephone_number": "859-212-4625",
            "fax_number": "859-212-4638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVERSO",
        "first_name": "KAILEE",
        "middle_name": "L",
        "credential": "MS, RD, CDE, CD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-12",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI 60373150",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KY",
            "license": "288658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAILEE",
            "last_name": "FARNUM",
            "middle_name": "L",
            "credential": "MS, RD, CD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Florence, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; 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.