Individual provider Active NPI

Alyson Wickemeyer, RD

  • Registered Dietitian
  • Kinston, NC
National Provider Identifier
1184472177
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L006356 Issued in NC
Practice address
1435 Highway 258N
Kinston, NC 28504-7208
Phone
(252) 523-9094
NPI assigned
May 7, 2024
Last updated
May 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2024

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 L006356 NC Primary

Addresses

Primary practice location

1435 Highway 258N
Kinston, NC 28504-7208

Mailing address

1832 Umstead St
Charlotte, NC 28205-2348
Phone (330) 806-6595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250212000597 NY Practitioner - Registered Dietitian Or Nutrition Professional 6103356787 Reassigns benefits to 1 organization
I20260325003815 PA Practitioner - Registered Dietitian Or Nutrition Professional 6103356787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
On-Point Nutrition LLCGroup PAC ID 6103268107, 2 clinicians
Sarah Lynn Nutrition PLLCGroup PAC ID 3072045947, 19 clinicians

Practice addresses (Care Compare)

503 Washington Ave
Suite 2C
Newtown, PA 18940-2153
Phone (855) 932-4048

5100 W Genesee St
Camillus, NY 13031-2354
Phone (315) 401-0590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012144NYMDNutrition Chiropractor
L006356NCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Lynn Nutrition Dietitian, Registered CurrentSince Dec 8, 2024 Accepting new patients
Lindatroia,LCSW, P.C. PastSince Dec 8, 2024 Accepting new patients

Locations

5100 W Genesee St
Camillus, NY 13031
Phone (315) 401-0590

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": "1715040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1184472177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1832 UMSTEAD ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282052348",
            "telephone_number": "330-806-6595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 HIGHWAY 258N",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285047208",
            "telephone_number": "252-523-9094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKEMEYER",
        "first_name": "ALYSON",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-07",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L006356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kinston, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.