Active NPI
Chantelle A Raines, RD,LDN
- Registered Dietitian
- White Plains, MD
National Provider Identifier
1124629761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DX5121
- Practice address
- 4560 Crain Hwy Ste 1
White Plains, MD 20695-3084 - Phone
- (240) 210-9725
- NPI assigned
- Nov 2, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86116533 | LA | |
| Registered Dietitian | 133V00000X | DX5121 | MD | Primary |
Addresses
Primary practice location
4560 Crain Hwy Ste 1
White Plains, MD 20695-3084
Mailing address
2708 Conor CT
Marrero, LA 70072-6270
Phone (904) 469-4512
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 |
|---|---|---|---|
| 86116533 | LA | MD | Registered Dietitian |
| DX5121 | MD | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marjorie Nolan Cohn LLC | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604534400000",
"number": "1124629761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2708 CONOR CT",
"city": "MARRERO",
"state": "LA",
"postal_code": "700726270",
"telephone_number": "904-469-4512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4560 CRAIN HWY STE 1",
"city": "WHITE PLAINS",
"state": "MD",
"postal_code": "206953084",
"telephone_number": "240-210-9725"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAINES",
"first_name": "CHANTELLE",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "RD,LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-02",
"last_updated": "2020-11-05",
"certification_date": "2020-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "LA",
"license": "86116533",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": "MD",
"license": "DX5121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.