Jacqueline Davis, RDN, LDN, IBCLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

96253419 Issued in NC

Practice address

371 NC Highway 65
Reidsville, NC 27320-8881

Phone

(336) 342-8201

NPI assigned

Mar 18, 2025

Last updated

Mar 18, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in NC

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2010

Medicare assignment

May accept Medicare assignment

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rockingham County Finance Office

  dba Rockingham County Public Health

  • State or Local Public Health Clinic/Center
  • Reidsville, NC
  • NPI 1306947445
  Medicare reassignment NPD

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

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1275333148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 NC HIGHWAY 65",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273208881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 NC HIGHWAY 65",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273208881",
            "telephone_number": "336-342-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JACQUELINE",
        "name_prefix": "Mrs.",
        "credential": "RDN, LDN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "NC",
            "license": "L-122675",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "96253419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary D Crumpton, RD, LDN
• Curis at Reidsville Opco LLC (Curis at Reidsville Transitional Care & Rehabilitation Center)
• Karen E Daniel, CRNA
• Daphne's Family Care Home
• Angelica Marcia Davis, RN
• Jacqueline Davis
• Sydney Ashlynne Dawson, MA, LPCA
• Daymark Recovery Services Inc
• Daymark Recovery Services Inc
• Daymark Recovery Services Inc

• Registered Dietitian in Reidsville, NC
• Providers in Reidsville, 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 Mar 18, 2025; 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.