ALEXANDRA JEAN LEAVITT (RD) – Registered Dietitian, NPI 1639677990

ALEXANDRA JEAN LEAVITT (RD) is a healthcare provider. based in Ogden, Utah. specializing in REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL. They hold the professional credentials RD. They hold a License No. 12142067-4901 (UT). The NPI Number for ALEXANDRA JEAN LEAVITT (RD) is 1639677990

Main info

Female
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
ALEXANDRA JEAN LEAVITT (RD)
NPI
1639677990
Phone
(385) 350-8500
Address
4345 HARRISON BLVD # 101
Enumeration Date
31 January 2018
Last Update Date
30 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3853508500
Graduation Year
2020 (6 years ago)
PAC ID
6608236278
Group Practice PAC ID
7719306091
Professional Enrollment ID
I20230713002835
Address ID
UT844033103OG4345XBLVD302
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:8State licenses:1Digital endpointsOther names

76 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in UT

Provider Addresses for ALEXANDRA JEAN LEAVITT (RD)

  • 4345 HARRISON BLVD # 101

    OGDEN, UT 844033103

    Phone: (385) 350-8500

    Type: Location

  • 971, South 800 West, Brigham City, Box Elder County, Utah, 84302, United States

    BRIGHAM CITY, UT 843023042

    Phone:

    Type: Mailing

  • 1755, North 200 East, North Logan, Cache County, Utah, 84341, United States

    North Logan, UT 843411915

    Phone: (435) 753-6245

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-07-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230713002835IRegistered Dietitian Or Nutrition ProfessionalUTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84403)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7719306091View full group profile
NameSpecialtyState
Nephrology, Internal MedicineUT
N E P H R O L O G YUT
Nurse PractitionerUT
Nurse PractitionerUT

Reviews

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Frequently asked questions

What is the standard ID for ALEXANDRA JEAN LEAVITT (RD) in the U.S.?
In the U.S., ALEXANDRA JEAN LEAVITT (RD) is identified by NPI 1639677990.
Is ALEXANDRA JEAN LEAVITT (RD) currently accepting referrals based on NPI status?
Registry metadata lists ALEXANDRA JEAN LEAVITT (RD) as active.
What services align with ALEXANDRA JEAN LEAVITT (RD)'s listing?
ALEXANDRA JEAN LEAVITT (RD)'s public classification highlights Registered Dietitian. Clinical services aligned with this taxonomy classification.
What city is tied to ALEXANDRA JEAN LEAVITT (RD)?
The directory associates ALEXANDRA JEAN LEAVITT (RD) with Ogden, Utah. Check all listed addresses for suites or satellite offices.
Who maintains ALEXANDRA JEAN LEAVITT (RD)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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