Individual provider Active NPI

Laura Rose Dragon, MS, RD, LDN

  • Registered Dietitian
  • Charlotte, NC
National Provider Identifier
1063927614
Registry record updated Dec 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L006110 Issued in NC
Practice address
4751 Mount Royal LN
Charlotte, NC 28210-4690
Phone
(607) 743-6253
Fax
(704) 259-4120
NPI assigned
Dec 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X L006110 NC Primary
Registered Dietitian 133V00000X 009198-1 NY

Addresses

Primary practice location

4751 Mount Royal LN
Charlotte, NC 28210-4690

Mailing address

4751 Mount Royal LN
Charlotte, NC 28210-4690
Phone (607) 743-6253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L006110NCMDRegistered Dietitian
009198-1NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Laura Rose Functional Nutrition Dietitian, Registered CurrentSince Jan 4, 2026 Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

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": "1512432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766880000000",
    "number": "1063927614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4751 MOUNT ROYAL LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282104690",
            "telephone_number": "607-743-6253",
            "fax_number": "704-259-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4751 MOUNT ROYAL LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282104690",
            "telephone_number": "607-743-6253",
            "fax_number": "704-259-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAGON",
        "first_name": "LAURA",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "MS, RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-05",
        "last_updated": "2025-12-28",
        "certification_date": "2025-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L006110",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "009198-1",
            "primary": false
        }
    ],
    "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 Dec 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.