Carly Fancher, MS, RDN, LD/N

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND7308 Issued in FL

Practice address

4180 N Orion Blvd BLDG 77
Orlando, FL 32816-8029

Phone

(336) 905-5966

NPI assigned

Sep 10, 2020

Last updated

Sep 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: carlyfancher@tdh.allscriptsdirect.net

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.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Dietitian, Registered

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1225643810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 MAJESTIC BAY LN APT 406",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327083155",
            "telephone_number": "336-905-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4180 N ORION BLVD BLDG 77",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328168029",
            "telephone_number": "336-905-5966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANCHER",
        "first_name": "CARLY",
        "credential": "MS, RDN, LD/N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND7308",
            "primary": true
        },
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bensen Benjamin Fan, M.D.
• Diana Fan, MD
• John R. Fan, MD
• Kristina Alison Fan
• Naim Fanaian, M.D.
• Lydia Fancher, PHARMD
• Qiuna Fang
• Xin Fang, BCBA
• Libertad Fantauzzi
• Carole L Farace, MS,RD,LD

• Registered Dietitian in Orlando, FL
• Providers in Orlando, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.

Verify at the official NPI Registry.