Charlotte Bell Jackson, MPH, RD, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

L002494 Issued in NC

Practice address

231 N Judd Pkwy NE
Fuquay Varina, NC 27526-2694

Phone

(919) 235-6410

NPI assigned

Nov 17, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wake Specialty Physicians LLCGroup PAC ID 7416006085, 178 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Wake Specialty Physicians, LLC

  • Surgery Physician
  • Raleigh, NC
  • NPI 1942440375
  Medicare reassignment Care Compare group NPD
• Wakemed Specialists Group, LLC

  • Cardiovascular Disease Physician
  • Raleigh, NC
  • NPI 1588227839
  Medicare reassignment NPD
• Wake Specialty Physicians LLC

  • Family Medicine Physician
  • Fuquay Varina, NC
  • NPI 1326394990
  NPD
• Wake Specialty Physicians LLC

  • Pediatrics Physician
  • Fuquay Varina, NC
  • NPI 1578334892
  NPD
• Wakemed Specialists Group LLC

  • Cardiac Rehabilitation Registered Nurse
  • Raleigh, NC
  • NPI 1063304228
  NPD
• Wakemed Specialists Group, LLC

  • Pediatric Obesity Medicine Physician
  • Raleigh, NC
  • NPI 1962067314
  NPD

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1003143777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602195",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602195",
            "telephone_number": "919-350-0351",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 N JUDD PKWY NE",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262694",
            "telephone_number": "919-235-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHARLOTTE",
        "middle_name": "BELL",
        "credential": "MPH, RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-17",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L002494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003143777",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inner Strength Therapeutic Services, PLLC
• Instride Foot and Ankle Specialists, PLLC
• Integrative Pediatric Therapy P.C.
• Integrative Sleep Wake Health, PLLC
• Iron Varsity, LLC
• Zina Jackson, LICSW
• Hayley F Jacobs
• Melanie Jacobs, COTA/L
• Michael Jacobs IV, FNP-BC
• Rachel Anne Jaffry

• Registered Dietitian in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.