Active NPI
Angela Davis, RDN
- Registered Dietitian
- Charlotte, NC
National Provider Identifier
1306670765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- L007991
- Practice address
- 2101 Rexford Rd Ste 50W
Charlotte, NC 28211-3497 - Phone
- (704) 900-5866
- NPI assigned
- Aug 28, 2024
- Last updated
- Aug 28, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | L007991 | NC | Primary |
Addresses
Primary practice location
2101 Rexford Rd Ste 50W
Charlotte, NC 28211-3497
Mailing address
801 Queens Rd
Charlotte, NC 28207-1629
Phone (980) 355-1654
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L007991 | NC | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724803200000",
"number": "1306670765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 QUEENS RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282071629",
"telephone_number": "980-355-1654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 REXFORD RD STE 50W",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282113497",
"telephone_number": "704-900-5866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "ANGELA",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-28",
"last_updated": "2024-08-28",
"certification_date": "2024-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L007991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.