NPIMap

Organization Active NPI

North Carolina State University

  • Registered Dietitian
  • Raleigh, NC
National Provider Identifier
1104304286
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
NORTH CAROLINA STATE UNIVERSITY
Practice address
4101 Beryl Rd Ste 230
Raleigh, NC 27606-1002
Phone
(919) 515-7665
NPI assigned
Aug 1, 2018
Organization subpart
Yes
Parent organization
NORTH CAROLINA STATE UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Authorized official

Name
Carolyn Dunn, PHD, RD, LDNNPI 1407281645
Title
Professor Emerita
Phone
(919) 605-6169

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

4101 Beryl Rd Ste 230
Raleigh, NC 27606-1002

Mailing address

North Carolina State University Ofa Campus Box 7201
Raleigh, NC 27695-7201
Phone (919) 513-7982

Other names 1

  • NCSU Eat Smart, Move More, Weigh Less Other name

National Provider Directory

National Provider Directory
Tax ID family
NC State University Student Health4 organizations share this tax ID, including this one
Part of
NC State University Student Health

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4101 Beryl Rd
Ste 230
Raleigh, NC 27606
Phone (919) 515-7665

7201 N Carolina State University Ofa Campus Box
Raleigh, NC 27695

512 Brickhaven Dr
Raleigh, NC 27606
Phone (919) 707-5225

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650412800000",
    "number": "1104304286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NORTH CAROLINA STATE UNIVERSITY OFA CAMPUS BOX 7201",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276957201",
            "telephone_number": "919-513-7982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 BERYL RD STE 230",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276061002",
            "telephone_number": "919-515-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA STATE UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH CAROLINA STATE UNIVERSITY",
        "enumeration_date": "2018-08-01",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "PROFESSOR EMERITA",
        "authorized_official_telephone_number": "919-605-6169",
        "authorized_official_credential": "PHD, RD, LDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NCSU Eat Smart, Move More, Weigh Less",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "NCSU Eat Smart, Move More, Weigh Less",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.