Mary Jacqueline Charlier, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

899879 Issued in GA

Practice address

1497 Fair Rd Ste 200
Statesboro, GA 30458-0824

Phone

(912) 871-7100

NPI assigned

May 28, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Jacqueline Ingraham Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1285200493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 MCCALL BLVD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304614922",
            "telephone_number": "319-594-5695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1497 FAIR RD STE 200",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580824",
            "telephone_number": "912-871-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLIER",
        "first_name": "MARY",
        "middle_name": "JACQUELINE",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "899879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "INGRAHAM",
            "middle_name": "JACQUELINE",
            "credential": "RDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kendra Ashley Chandler
• Maryn Clements Chandler, PA-C
• Athena Paraskevi Chapel, D.M.D.
• Bryan Chapman, R.PH.
• Anthony B. Chappell, M.D.
• El Donna M Chase-Hilde, WHPN
• Teresa Brower Cheney, FNP
• Tressa G Cheney, NURSE PRACTITIONER
• Nicole Cherrett
• Olivia Anne Chester, MOT, OTR/L

• Registered Dietitian in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Registered Dietitian in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.