Active NPI
Carla J Wiederholt, RD,LDN,CNSD
- Registered Dietitian
- Bel Air, MD
National Provider Identifier
1346380854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D01851
- Practice address
- 500 Upper Chesapeake Dr
Food and Nutrition Department
Bel Air, MD 21014-4324 - Phone
- (443) 643-2736
- Fax
- (443) 643-2170
- NPI assigned
- Feb 7, 2007
- Sex
- Female
- Sole proprietor
- No
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 | D01851 | MD | Primary |
Addresses
Primary practice location
500 Upper Chesapeake Dr
Food and Nutrition Department
Bel Air, MD 21014-4324
Mailing address
500 Upper Chesapeake Dr
Food and Nutrition Department
Bel Air, MD 21014-4324
Phone (443) 643-2736
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 105114 | Other | MD | JHU |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D01851 | MD | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346380854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 UPPER CHESAPEAKE DR",
"address_2": "FOOD AND NUTRITION DEPARTMENT",
"city": "BEL AIR",
"state": "MD",
"postal_code": "210144324",
"telephone_number": "443-643-2736",
"fax_number": "443-643-2170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 UPPER CHESAPEAKE DR",
"address_2": "FOOD AND NUTRITION DEPARTMENT",
"city": "BEL AIR",
"state": "MD",
"postal_code": "210144324",
"telephone_number": "443-643-2736",
"fax_number": "443-643-2170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIEDERHOLT",
"first_name": "CARLA",
"middle_name": "J",
"credential": "RD,LDN,CNSD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MD",
"license": "D01851",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JHU",
"identifier": "105114",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bel Air, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.