Active NPI
Leandra J Philip, RD
- Registered Dietitian
- Colorado Springs, CO
National Provider Identifier
1972348225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86110151
- Practice address
- 2410 Busch Ave Lot 24
Colorado Springs, CO 80904-4175 - Phone
- (936) 697-3717
- NPI assigned
- Jun 27, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86110151 | CO | Primary |
Addresses
Primary practice location
2410 Busch Ave Lot 24
Colorado Springs, CO 80904-4175
Mailing address
2410 Busch Ave Lot 24
Colorado Springs, CO 80904-4175
Phone (936) 697-3717
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86110151 | CO | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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": "1719446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719792000000",
"number": "1972348225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2410 BUSCH AVE LOT 24",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809044175",
"telephone_number": "936-697-3717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2410 BUSCH AVE LOT 24",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809044175",
"telephone_number": "936-697-3717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILIP",
"first_name": "LEANDRA",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-27",
"last_updated": "2024-07-01",
"certification_date": "2024-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CO",
"license": "86110151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.