Active NPI
Marisha Leaira Beaver, RD
- Registered Dietitian
- Charlotte, NC
National Provider Identifier
1225673270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- L005925
- Practice address
- 7004 Smith Corners Blvd Ste a
Charlotte, NC 28269-3827 - Phone
- (704) 688-9650
- NPI assigned
- Nov 14, 2019
- 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 | L005925 | NC | Primary |
Addresses
Primary practice location
7004 Smith Corners Blvd Ste a
Charlotte, NC 28269-3827
Mailing address
7004 Smith Corners Blvd Ste a
Charlotte, NC 28269-3827
Phone (704) 688-9650
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 |
|---|---|---|---|
| L005925 | NC | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573689600000",
"number": "1225673270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7004 SMITH CORNERS BLVD STE A",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282693827",
"telephone_number": "704-688-9650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7004 SMITH CORNERS BLVD STE A",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282693827",
"telephone_number": "704-688-9650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAVER",
"first_name": "MARISHA",
"middle_name": "LEAIRA",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-14",
"last_updated": "2019-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L005925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
- Renee Beauregard, MSN, PMHNP-BC, RN
- Beautiful Way Counseling, PLLC
- Beautifully Made Counseling and Consulting, LLC
- Ethan Lee Beaver, MA, LCAS-A
- Laura A Beaver, CSACR
- Robert David Beaver
- Walter Burns Beaver Jr., MD
- Because We Care Patient Advocate Inc
- Rabih Ibrahim Bechara, MD
- Charles Lindsay Beck, MSW, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.