Active NPI
Jennifer Campbell Johnson, MS, RDN, LDN, IFNCP
- Registered Dietitian
- Raleigh, NC
National Provider Identifier
1386466654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- L007258
- Practice address
- 8801 Fast Park Dr Ste 301
Raleigh, NC 27617-4853 - Phone
- (910) 663-5166
- Fax
- (888) 856-3502
- NPI assigned
- Oct 29, 2024
- 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 | L007258 | NC | Primary |
Addresses
Primary practice location
8801 Fast Park Dr Ste 301
Raleigh, NC 27617-4853
Mailing address
1229 Shining Water LN
Creedmoor, NC 27522-7246
Phone (919) 632-5283
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 |
|---|---|---|---|
| L007258 | NC | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LG Nutrition LLC | Dietitian, Registered | Past | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730160000000",
"number": "1386466654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1229 SHINING WATER LN",
"city": "CREEDMOOR",
"state": "NC",
"postal_code": "275227246",
"telephone_number": "919-632-5283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8801 FAST PARK DR STE 301",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276174853",
"telephone_number": "910-663-5166",
"fax_number": "888-856-3502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JENNIFER",
"middle_name": "CAMPBELL",
"credential": "MS, RDN, LDN, IFNCP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-29",
"last_updated": "2024-10-29",
"certification_date": "2024-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L007258",
"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 Oct 29, 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.