Individual provider Active NPI

Stephanie Gayles, MS, RD, LDN

  • Registered Dietitian
  • Fayetteville, NC
National Provider Identifier
1295047207
Registry record updated Jul 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
896950 Issued in NC
Practice address
1235 Ramsey St
Fayetteville, NC 28301-4401
Phone
(910) 433-3764
Fax
(910) 433-3661
NPI assigned
Jul 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 896950 NC Primary

Addresses

Primary practice location

1235 Ramsey St
Fayetteville, NC 28301-4401

Mailing address

202 E 13TH St
Lumberton, NC 28358-4729
Phone (910) 736-7619

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
896950NCMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278460800000",
    "number": "1295047207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E 13TH ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283584729",
            "telephone_number": "910-736-7619",
            "fax_number": "910-433-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 RAMSEY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283014401",
            "telephone_number": "910-433-3764",
            "fax_number": "910-433-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYLES",
        "first_name": "STEPHANIE",
        "name_prefix": "Ms.",
        "credential": "MS, RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-07",
        "last_updated": "2010-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "896950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2010; 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.