Susan Lynn Leslie, MS, RDN

Primary specialty

Renal Nutrition Registered DietitianTaxonomy code 133VN1005X

Practice address

7810 Ballantyne Commons Pkwy Ste 221
Charlotte, NC 28277-3416

Phone

(704) 995-3434

NPI assigned

Nov 3, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Fuel 4 Life

  • Registered Dietitian
  • Charlotte, NC
  • NPI 1124377502
  NPD

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1942917448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 PRIMROSE LANE",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481973213",
            "telephone_number": "734-604-8266",
            "fax_number": "833-315-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7810 BALLANTYNE COMMONS PKWY STE 221",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773416",
            "telephone_number": "704-995-3434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3051 Primrose Ln",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481973213",
            "country_code": "US",
            "telephone_number": "734-604-8266",
            "fax_number": "833-315-0019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LESLIE",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "credential": "MS, RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-03",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Smith Lesesne, MA, LPC
• Leslie H Petruk Ma LPC NCC
• Leslie M Anderson OD PA
• Leslie Van Horn Nutrition LLC
• Alberto Leslie
• Madison Marie Lesniak
• Anna Layne Leson, SLP
• Timothy A Lesondak, DPT
• Aaron D Less, PH.D.
• Trinity Tyne Lesser

• Renal Nutrition Registered Dietitian in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Renal Nutrition Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.