Coretta Queen Chaffin

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

810909 Issued in NC

Practice address

7940 Williams Pond LN Ste 150
Charlotte, NC 28277-8409

Phone

(704) 247-8355

NPI assigned

Aug 25, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Coretta Queen Clemmons Former name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dietitian Services LLCGroup PAC ID 6507237856, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dietitian Services LLC

  • Clinic/Center
  • Matthews, NC
  • NPI 1982311809
  Medicare reassignment Care Compare group NPD
• My Diabetes Dietitian, Inc.

  • Registered Dietitian
  • Matthews, NC
  • NPI 1134368947

  Dietitian, Registered

  Medicare reassignment NPD
• Dietitians Helping Dietitians LLC

  • Registered Dietitian
  • Charlotte, NC
  • NPI 1083218655

  Dietitian, Registered

  NPD (past)
• Transcend Nutrition Counseling, LLC

  • Registered Dietitian
  • Charlotte, NC
  • NPI 1043601172

  Dietitian, Registered

  NPD (past)
• Cloud Health Medical Group of New Jersey, P.C.

  • Internal Medicine Physician
  • Union City, NJ
  • NPI 1043995467
  NPD (past)
• Cloud Health Medical Group, P.a.

  • Internal Medicine Physician
  • White Plains, NY
  • NPI 1528744935
  NPD (past)
• Marjorie Nolan Cohn LLC

  • Registered Dietitian
  • New York, NY
  • NPI 1760825160

  Dietitian, Registered

  NPD (past)
• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1255944716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3717 OLD WAGON RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282691994",
            "telephone_number": "704-562-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7940 WILLIAMS POND LN STE 150",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282778409",
            "telephone_number": "704-247-8355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAFFIN",
        "first_name": "CORETTA",
        "middle_name": "QUEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-25",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "810909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORETTA",
            "last_name": "CLEMMONS",
            "middle_name": "QUEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Dinesh Chadha, MD
• Shannon N Chadha, MD
• Lucy Allen Chadis, CCC/SLP
• Victoria Cole Chadwick, M.DIV.M.A.,LPC
• Jenna Leigh Chaffee, M.S., CCC-SLP
• Janie Yun Chai, MD
• Seungjean Chai, MD
• Rebecca Chain, PT, DPT
• Chair & Equipment Rentals and Sales
• Joshua Samuel Chait

• Registered Dietitian in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.