Individual provider Active NPI

Callie R Huneycutt, RD, LDN

  • Registered Dietitian
  • Pinehurst, NC
National Provider Identifier
1144767815
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L004992 Issued in NC
Practice address
15 Regional Dr
Pinehurst, NC 28374-8850
Phone
(910) 235-3492
NPI assigned
Jan 19, 2017
Last updated
Mar 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X L004992 NC Primary

Addresses

Primary practice location

15 Regional Dr
Pinehurst, NC 28374-8850

Mailing address

205 Page Rd
Pinehurst, NC 28374-8749
Phone (910) 295-5511

Other practice location 1

555 Carthage St
Sanford, NC 27330-4104
Phone (919) 774-6518

Other names 1

  • Callie E Ricketts Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170308001843 NC Practitioner - Registered Dietitian Or Nutrition Professional 3678857794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pinehurst Medical Clinic IncGroup PAC ID 5991617169, 162 clinicians

Practice addresses (Care Compare)

555 Carthage St
Sanford, NC 27330-4104
Phone (919) 774-6518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pinehurst Medical Clinic, Inc. CurrentSince Jan 23, 2017 Accepting new patients
Pinehurst Medical Clinic, Inc. CurrentSince Jan 23, 2017 Accepting new patients
Pinehurst Medical Clinic, Inc. Past Accepting new patients

Locations

15 Regional Dr
Pinehurst, NC 28374
Phone (910) 255-4400

205 Page Rd
Pinehurst, NC 28374
Phone (910) 295-9211

45 Aviemore Dr
Pinehurst, NC 28374
Phone (910) 235-3347

1411 Greenway Ct
Sanford, NC 27330
Phone (919) 292-1878

555 Carthage St
Sanford, NC 27330
Phone (919) 774-6518

Organizations & group practices 3

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": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1144767815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 PAGE RD",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748749",
            "telephone_number": "910-295-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 REGIONAL DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748850",
            "telephone_number": "910-235-3492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 CARTHAGE ST",
            "address_purpose": "LOCATION",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304104",
            "country_code": "US",
            "telephone_number": "919-774-6518",
            "fax_number": "919-774-1831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUNEYCUTT",
        "first_name": "CALLIE",
        "middle_name": "R",
        "credential": "RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-19",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L004992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CALLIE",
            "last_name": "RICKETTS",
            "middle_name": "E",
            "credential": "RD, LDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pinehurst, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.