Active NPI
Katti Laine Jackson, MS, RD, LDN
- Registered Dietitian
- Raleigh, NC
National Provider Identifier
1346739117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- L005393
- Practice address
- 14032 Kennington Park Dr Apt 306
Raleigh, NC 27614-6994 - Phone
- (573) 318-6551
- NPI assigned
- May 7, 2018
- 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 | L005393 | NC | Primary |
Addresses
Primary practice location
14032 Kennington Park Dr Apt 306
Raleigh, NC 27614-6994
Mailing address
14032 Kennington Park Dr Apt 306
Raleigh, NC 27614-6994
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nutritious Thoughts | Dietitian, Registered | Current | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Locations
31 College Pl
Ste 200
Asheville, NC 28801
Phone (828) 279-7091
1612 Asheville Hwy
Ste 1
Hendersonville, NC 28791
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525651200000",
"number": "1346739117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14032 KENNINGTON PARK DR APT 306",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276146994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14032 KENNINGTON PARK DR APT 306",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276146994",
"telephone_number": "573-318-6551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "KATTI",
"middle_name": "LAINE",
"name_prefix": "Mrs.",
"credential": "MS, RD, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-07",
"last_updated": "2018-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L005393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.