Active NPI
Andrea Carlisle, RDN
- Registered Dietitian
- Raleigh, NC
National Provider Identifier
1124731195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- L006081
- Practice address
- 1603 Hillsborough St
Raleigh, NC 27605 - Phone
- (919) 604-6690
- NPI assigned
- Jan 4, 2023
- Last updated
- Jan 4, 2023
- Sex
- Female
- Sole proprietor
- No
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 | L006081 | NC | Primary |
Addresses
Primary practice location
1603 Hillsborough St
Raleigh, NC 27605
Mailing address
319 Fayetteville St Unit 415
Raleigh, NC 27601-1976
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L006081 | NC | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rdnutrition 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Loop Nutrition
- Registered Dietitian
- Durham, NC
- NPI 1104642859
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672790400000",
"number": "1124731195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "319 FAYETTEVILLE ST UNIT 415",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276011976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1603 HILLSBOROUGH ST",
"city": "RALEIGH",
"state": "NC",
"postal_code": "27605",
"telephone_number": "919-604-6690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLISLE",
"first_name": "ANDREA",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-04",
"last_updated": "2023-01-04",
"certification_date": "2023-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L006081",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.