Individual provider Active NPI

Charlotte Wiltshire, RDN

  • Registered Dietitian
  • Myrtle Beach, SC
National Provider Identifier
1063804284
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
650 Issued in SC
Practice address
3236 Holmestown Rd
Suite E1
Myrtle Beach, SC 29588-7495
Phone
(843) 663-8000
NPI assigned
Feb 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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 650 SC Primary

Addresses

Primary practice location

3236 Holmestown Rd
Suite E1
Myrtle Beach, SC 29588-7495

Mailing address

PO Box 547
Little River, SC 29566-0547
Phone (843) 663-8000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150507000569 SC Practitioner - Registered Dietitian Or Nutrition Professional 1658690078 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
650SCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Little River Medical Center Inc CurrentSince Feb 18, 2015 Accepting new patients
Little River Medical Center, Inc. CurrentSince Feb 18, 2015 Accepting new patients

Locations

4303 Live Oak Dr
Little River, SC 29566
Phone (803) 839-3939

3236 Holmestown Rd
Unit E1
Myrtle Beach, SC 29588

Organizations & group practices 2

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": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1063804284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295660547",
            "telephone_number": "843-663-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3236 HOLMESTOWN RD",
            "address_2": "SUITE E1",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295887495",
            "telephone_number": "843-663-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILTSHIRE",
        "first_name": "CHARLOTTE",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-25",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SC",
            "license": "650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; 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.