LESLIE MARIE ANDERSON (NPI# 1114242781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114242781 |
| Entity Type | Individual |
| Full Name | LESLIE MARIE ANDERSON |
| Other Name | LESLIE A. WIMBERLEY |
| Credential | LDN RD |
| Practice Address |
1005 Mar Walt Dr Fort Walton Beach FL 32547-6707 |
| Mailing Address |
1005 Mar Walt Drive Fort Walton Beach FL 32547-6707 |
| Practice Telephone | 8508636600 |
| Mailing Telephone | 8508636600 |
| Mailing Fax Number | 8508620972 |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2019-12-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | ND9301 | FL | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821460536 | Leslie Anderson | Massage Therapist | 1730 Sw Parkway Dr, Redmond, OR 97756-2543 | 2015-10-21 |
| 1679813497 | Leslie Rae Anderson | Marriage & Family Therapist | 505 S Mcclelland St Ste A, Santa Maria, CA 93454-5186 | 2013-02-15 |
| 1275879041 | Leslie V Anderson | Dietitian, Registered | 609 W 1600 S, Woods Cross, UT 84087-1606 | 2012-12-21 |
| 1376866723 | Leslie Anderson | Physical Therapist | 4200 County Road 64 E, Avon Park, FL 33825-9794 | 2010-03-11 |
| 1477727485 | Leslie Lockett Anderson | Acupuncturist | 9170 Rt 108, Suite 202, Columbia, MD 21045 | 2008-04-22 |
| 1558424135 | Leslie A. Anderson | Specialist | 451a Carlisle Dr, Herndon, VA 20170-4819 | 2006-12-18 |
| 1356940472 | Leslie A Anderson | Counselor | 6995 W 48th St, Fremont, MI 49412-9506 | 2020-10-20 |
| 1538797261 | Leslie Olivia Anderson | Student in an Organized Health Care Education/Training Program | 3501 Johnson St, Hollywood, FL 33021-5421 | 2020-03-30 |
| 1508347352 | Leslie Paige Anderson | Speech-Language Pathologist | 4501 Dudmar Dr, Austin, TX 78735-6913 | 2018-08-28 |
| 1720573009 | Leslie Anderson | Pathology | 5570 Overland Ave Ste 101, San Diego, CA 92123-1215 | 2018-06-28 |
| Street Address |
1005 MAR WALT DR |
| City | FORT WALTON BEACH |
| State | FL |
| Zip Code | 32547-6707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174517627 | Michael Andrew Johnson | Physician Assistant | 1005 Mar Walt Dr, Internal Medicine Department, Fort Walton Beach, FL 32547-6707 | 2005-09-09 |
| 1023658408 | Katelyn Elaine Dye | Nurse Practitioner | 1005 Mar Walt Dr, Fort Walton Beach, FL 32547-6707 | 2020-01-13 |
| 1467988220 | Katrina Pendleton Borner | Nurse Practitioner | 1005 Mar Walt Dr, Fort Walton Beach, FL 32547-6707 | 2017-05-11 |
| 1992067383 | Irina Viktorovna Smith | Pediatrics | 1005 Mar Walt Dr, Fort Walton Beach, FL 32547-6707 | 2012-06-12 |
| 1134267537 | White-wilson Medical Center, P.a. | Family Medicine | 1005 Mar Walt Dr, Fp Department, Fort Walton Beach, FL 32547-6707 | 2007-02-01 |
| 1518005917 | White-wilson Medical Center, P.a. | Pediatrics | 1005 Mar Walt Dr, Pediatric Department, Fort Walton Beach, FL 32547-6707 | 2007-02-01 |
| 1669410924 | Charles Joseph Clancy | Emergency Medicine | 1005 Mar Walt Dr, Immediate Care Department, Fort Walton Beach, FL 32547-6707 | 2006-06-02 |
| 1275519886 | Lawrence P King | Pediatrics | 1005 Mar Walt Dr, Pediatric Department, Fort Walton Beach, FL 32547-6707 | 2005-12-16 |
| 1336124098 | Harold Timothy Johnson | Physician Assistant | 1005 Mar Walt Dr, Family Medicine Department, Fort Walton Beach, FL 32547-6707 | 2005-12-14 |
| 1790760502 | Gilberto Luis Vigo | Internal Medicine | 1005 Mar Walt Dr, Internal Medicine Department, Fort Walton Beach, FL 32547-6707 | 2005-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255944955 | Theresa Ann Morvay | Behavior Technician | 419 Racetrack Rd Ne, Fort Walton Beach, FL 32547 | 2020-08-24 |
| 1588295422 | Emily Ann Glossop | Nurse Practitioner | 930 Mar Walt Drive C, Fort Walton Beach, FL 32547 | 2020-01-29 |
| 1225669443 | Elizabeth Rogers Nagengast | Physician Assistant | 930 Mar Walt Drive, Unit C, Fort Walton Beach, FL 32547 | 2020-01-27 |
| 1497254791 | Carmen Alston | Nurse Practitioner | 930 Mar Walt Dr C, Fort Walton Beach, FL 32547 | 2018-02-02 |
| 1871004960 | Center for Neuropsychological Services Cns | Clinical Neuropsychologist | 1817 Lewis Turner Blvd, Fort Walton Beach, FL 32547 | 2017-10-17 |
| 1194235648 | Robin Wray | Speech-Language Pathologist | 930 Mar Walt Dr D, Fort Walton Beach, FL 32547 | 2017-10-10 |
| 1285007989 | Dynamic Pain & Wellness Pllc | Pain Medicine | 930 Marwalt Drive, Suite B and C, Fort Walton Beach, FL 32547 | 2015-11-04 |
| 1013392810 | Terry Abbott | Social Worker | 648 Overbrook Dr, Fort Walton Beach, FL 32547 | 2015-07-22 |
| 1083024673 | Emily Lohr | Physical Therapy Assistant | 2000 Principle Ln, Ft. Walton Beach, FL 32547 | 2014-05-05 |
| 1831526102 | Laurie Ann Schweppe | Nurse Practitioner | 1005 Mar Walt Drivve, Snf Hospitalist Department, Fort Walton Beach, FL 32547 | 2013-10-02 |
| Find all providers in zip 32547 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013497163 | Ashley Leigh Selvey | Dietitian, Registered | 5 Elm Ave Se, Fort Walton Beach, FL 32548-5613 | 2018-08-17 |
| 1588189468 | Lauren Noelle Vardai | Dietitian, Registered | 339 Hollywood Blvd Nw, Fort Walton Beach, FL 32548-4659 | 2017-08-11 |
| 1053793158 | Christine Allegra Gast | Dietitian, Registered | 450 Kanuha Dr, Fort Walton Beach, FL 32547-5027 | 2015-06-24 |
| 1881823060 | Deanna M Howard-gonzalez | Dietitian, Registered | 217 Miracle Strip Pkwy Se, Fort Walton Beach, FL 32548-5819 | 2009-07-08 |
| 1700307550 | Emerald Coast Diabetes & Nutrition Center | Dietitian, Registered | 217 Miracle Strip Pkwy Se, Fort Walton Beach, FL 32548-5819 | 2017-07-02 |
| 1801842513 | Jennifer Poe | Dietitian, Registered | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 | 2006-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265268 | Rachel Moore Gibson | Dietitian, Registered | 5145 S Dale Mabry Hwy Unit 20412, Tampa, FL 33611-3677 | 2020-11-08 |
| 1275134520 | Dunia Santana-enamorado | Dietitian, Registered | 6141 Lanshire Dr, Tampa, FL 33634-3042 | 2020-11-03 |
| 1841890464 | Alice Sanchez | Dietitian, Registered | 7643 Gate Parkway, Suite 104-1128, Jacksonville, FL 32256 | 2020-11-01 |
| 1114527256 | Jacquelyn Gabriela Baldeon Garo | Dietitian, Registered | 17701 Sw 112th Ave, Miami, FL 33157-5007 | 2020-10-28 |
| 1013516632 | Cecelia Lee Andreo | Dietitian, Registered | 3545 Victory Dr, Pace, FL 32571-8302 | 2020-10-24 |
| 1114526209 | Scientific Nutrition International LLC | Dietitian, Registered | 6295 Sunset Dr, South Miami, FL 33143-4804 | 2020-10-20 |
| 1023617446 | Madisyn Becker | Dietitian, Registered | 871 Ibis Walk Pl N Unit 7203, Saint Petersburg, FL 33716-3843 | 2020-10-19 |
| 1194323774 | Janice Cuevas Cintron | Dietitian, Registered | 5439 Limestone Ln, Lakeland, FL 33809-0830 | 2020-10-15 |
| 1194323345 | Danielle Sara Samelson | Dietitian, Registered | 4225 Cloverleaf Pl, Casselberry, FL 32707-4703 | 2020-10-10 |
| 1518564830 | Sneha Lalla | Dietitian, Registered | 14171 Metropolis Ave Ste 202, Fort Myers, FL 33912-4335 | 2020-10-08 |
| Find all providers with the same taxonomy | ||||
| City | FORT WALTON BEACH |
| Zip Code | 32547 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.