Active NPI
Stephanie Williams McCullum, REGISTERED DIETITIAN
- Registered Dietitian
- Durham, NC
National Provider Identifier
1093519126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- L001707
- Practice address
- 208 Collegiate Cir
Durham, NC 27713-6001 - Phone
- (919) 949-6624
- NPI assigned
- Apr 1, 2025
- Last updated
- Apr 1, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | L001707 | NC | Primary |
Addresses
Primary practice location
208 Collegiate Cir
Durham, NC 27713-6001
Mailing address
208 Collegiate Cir
Durham, NC 27713-6001
Phone (919) 949-6624
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L001707 | NC | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743465600000",
"number": "1093519126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 COLLEGIATE CIR",
"city": "DURHAM",
"state": "NC",
"postal_code": "277136001",
"telephone_number": "919-949-6624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 COLLEGIATE CIR",
"city": "DURHAM",
"state": "NC",
"postal_code": "277136001",
"telephone_number": "919-949-6624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCULLUM",
"first_name": "STEPHANIE",
"middle_name": "WILLIAMS",
"name_prefix": "Mrs.",
"credential": "REGISTERED DIETITIAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-04-01",
"last_updated": "2025-04-01",
"certification_date": "2025-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L001707",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.