Charlene Maria Chan, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

L004739 Issued in NC

Practice address

1509 Doctors Cir
Wilmington, NC 28401-7403

Phone

(910) 662-7500

NPI assigned

May 23, 2023

Last updated

Apr 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Novant Health Medical Group Coastal Region, LLC

  dba NHMGCR Cape Fear Heart

  • Cardiovascular Disease Physician
  • Wilmington, NC
  • NPI 1649865791
  Medicare reassignment
• New Hanover Medical Group PA

  • Family Medicine Physician
  • Wilmington, NC
  • NPI 1992751374
  NPD (past)

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1083306674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 DOCTORS CIR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017403",
            "telephone_number": "910-662-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "CHARLENE",
        "middle_name": "MARIA",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-23",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L004739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carly Chambers
• Dana Renee Chambers, LPC
• Shelley Elizabeth Chambers, MSW LCSW
• Dailyn Chamnin, MSN, RN
• William Rataphon Chamnin, PA-C
• David Justin Chandler, PTA
• Josette Chandler, LCMHC
• Morgan Chandler, RBT
• Gowri Chandrashekar, MD
• Tiyana Kia Chaney-Taylor, PHD, LCSW, BC-TMH

• Registered Dietitian in Wilmington, NC
• Providers in Wilmington, 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 Apr 12, 2024; 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.