Individual provider Active NPI

Jennifer Hawthorne Ingraham, MS, RD, LDN

  • Registered Dietitian
  • Charlotte, NC
National Provider Identifier
1003625641
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L007386 Issued in NC
Practice address
4501 Cameron Valley Pkwy Ste 300
Charlotte, NC 28211-4368
Phone
(704) 381-8840
NPI assigned
Jan 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X L007386 NC Primary

Addresses

Primary practice location

4501 Cameron Valley Pkwy Ste 300
Charlotte, NC 28211-4368

Mailing address

1001 Blythe Blvd Ste 200
Charlotte, NC 28203-5865
Phone (704) 381-8840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250414001732 NC Practitioner - Registered Dietitian Or Nutrition Professional 1153845995 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
L007386NCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center CurrentSince Jun 5, 2025 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Medical Center CurrentSince Jun 5, 2025 Accepting new patients

Locations

1001 Blythe Blvd
Ste 200
Charlotte, NC 28203
Phone (704) 373-0544

1001 Blythe Blvd
Ste 601
Charlotte, NC 28203
Phone (704) 355-6930

4501 Cameron Valley Pkwy
Ste 300
Charlotte, NC 28211
Phone (704) 355-0101

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1090 NE Gateway Ct NE
Ste 204
Concord, NC 28025
Phone (704) 403-7020

Networks

  • devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

Organizations & group practices 3

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": "1736208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1003625641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BLYTHE BLVD STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035865",
            "telephone_number": "704-381-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 CAMERON VALLEY PKWY STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114368",
            "telephone_number": "704-381-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAHAM",
        "first_name": "JENNIFER",
        "middle_name": "HAWTHORNE",
        "credential": "MS, RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-07",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L007386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.