Active NPI
Mekenzie Lynn Riley, RD
- Registered Dietitian
- Cornelius, NC
National Provider Identifier
1194599480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1039274
- Practice address
- 19607 W Catawba Ave
Cornelius, NC 28031-4002 - Phone
- (704) 895-8000
- NPI assigned
- Nov 8, 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 | 1039274 | NC | Primary |
Addresses
Primary practice location
19607 W Catawba Ave
Cornelius, NC 28031-4002
Mailing address
19607 W Catawba Ave
Cornelius, NC 28031-4002
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 |
|---|---|---|---|
| 1039274 | NC | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Anna Turner LLC | Dietitian, Registered | Past | Accepting new patients |
| Anna Turner LLC | Dietitian, Registered | Past | Accepting new patients |
| Nutrition Healthworks LLC | Dietitian, Registered | Past | Accepting new patients |
| Ascanio Physical Therapy | Past | Accepting new patients |
Organizations & group practices 5
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.
-
- Physical Therapy Clinic/Center
- Cornelius, NC
- NPI 1679148787
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699401600000",
"number": "1194599480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19607 W CATAWBA AVE",
"city": "CORNELIUS",
"state": "NC",
"postal_code": "280314002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19607 W CATAWBA AVE",
"city": "CORNELIUS",
"state": "NC",
"postal_code": "280314002",
"telephone_number": "704-895-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RILEY",
"first_name": "MEKENZIE",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-08",
"last_updated": "2023-11-08",
"certification_date": "2023-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "1039274",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cornelius, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.