Individual provider Active NPI

Julie Kennedy, MPH, MED, RDN, LDN

  • Registered Dietitian
  • Holly Springs, NC
National Provider Identifier
1326507955
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L005684 Issued in NC
Practice address
113 Middlegreen PL
Holly Springs, NC 27540-5524
Phone
(984) 221-8101
NPI assigned
Mar 13, 2019
Last updated
Mar 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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 L005684 NC Primary

Addresses

Primary practice location

113 Middlegreen PL
Holly Springs, NC 27540-5524

Mailing address

113 Middlegreen PL
Holly Springs, NC 27540-5524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 30, 2020 through Dec 30, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
L005684NCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Julie Kennedy Nutrition Dietitian, Registered Current Accepting new patients

Organizations & group practices 1

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": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1326507955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 MIDDLEGREEN PL",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275405524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 MIDDLEGREEN PL",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275405524",
            "telephone_number": "984-221-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JULIE",
        "credential": "MPH, MED, RDN, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L005684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Springs, NC

Sources for this page

Verify at the official NPI Registry.