Active NPI
Jennifer F Greenly, MS, RD, LDN
- Registered Dietitian
- Winston Salem, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- L001762
- Practice address
- 114 Charlois Blvd
Winston Salem, NC 27103-1522 - Phone
- (336) 765-5470
- Fax
- (336) 499-5428
- NPI assigned
- Apr 23, 2008
- 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 | L001762 | NC | Primary |
Addresses
Primary practice location
114 Charlois Blvd
Winston Salem, NC 27103-1522
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-7840
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | JGREENLY4261@DIRECT.NOVANTHEALTH.ORG |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L001762 | NC | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Past | Accepting new patients |
Locations
4130 Clemmons Rd
Clemmons, NC 27012
Phone (336) 277-1890
14330 Oakhill Park Ln
Ste 200
Huntersville, NC 28078
Phone (704) 316-1265
5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441
114 Charlois Blvd
Winston Salem, NC 27103
2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300
Interoperability endpoints
- jgreenly4261@direct.novanthealth.org
Organizations & group practices 4
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.
-
- Neurology with Special Qualifications in Child Neurology Physician
- Charlotte, NC
- NPI 1366409492
-
- Surgery Physician
- Winston Salem, NC
- NPI 1063885614
-
- Obstetrics & Gynecology Physician
- Matthews, NC
- NPI 1386506137
-
- Internal Medicine Physician
- Charlotte, NC
- NPI 1134841802
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650326400000",
"number": "1265607147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60447",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282600447",
"telephone_number": "704-384-7840",
"fax_number": "704-384-7830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 CHARLOIS BLVD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271031522",
"telephone_number": "336-765-5470",
"fax_number": "336-499-5428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENLY",
"first_name": "JENNIFER",
"middle_name": "F",
"credential": "MS, RD, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-23",
"last_updated": "2022-04-19",
"certification_date": "2022-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L001762",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "JGREENLY4261@DIRECT.NOVANTHEALTH.ORG",
"affiliation": "N",
"address_1": "114 Charlois Blvd",
"city": "Winston Salem",
"state": "NC",
"country_code": "US",
"postal_code": "271031522",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.