Individual provider Active NPI

Julia Ngoc Nguyen, RD, LD, CDCES

  • Registered Dietitian
  • Raleigh, NC
National Provider Identifier
1356018741
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L006094 Issued in NC
Practice address
23 Sunnybrook Rd Ste 200
Raleigh, NC 27610-1855
Phone
(919) 350-7584
NPI assigned
Aug 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X
Pediatric Endocrinology Physician 2080P0205X 32300853 NC
Registered Dietitian 133V00000X L006094 NC Primary

Addresses

Primary practice location

23 Sunnybrook Rd Ste 200
Raleigh, NC 27610-1855

Mailing address

512 Brickhaven Dr
Raleigh, NC 27606-6345

Other practice location 1

512 Brickhaven Dr
Raleigh, NC 27606-6345
Phone (502) 817-5319

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

State licenses

LicenseStateTypeSpecialty
32300853NCMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group, LLC Current Accepting new patients
North Carolina State University Dietitian, Registered PastSince Aug 1, 2021 Accepting new patients
Wake Specialty Physicians, LLC PastSince Jan 21, 2024 Accepting new patients

Locations

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

23 Sunnybrook Rd
Raleigh, NC 27610
Phone (919) 322-4800

23 Sunnybrook Rd
Ste 200
Raleigh, NC 27610
Phone (919) 235-6435

Organizations & group practices 3

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": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1356018741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 BRICKHAVEN DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276066345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 SUNNYBROOK RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101855",
            "telephone_number": "919-350-7584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "512 Brickhaven Dr",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276066345",
            "country_code": "US",
            "telephone_number": "502-817-5319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JULIA",
        "middle_name": "NGOC",
        "credential": "RD, LD, CDCES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NC",
            "license": "32300853",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L006094",
            "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 Aug 19, 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.

Verify at the official NPI Registry.