Individual provider Active NPI

Fabiola Nicohl Quinones Rosa, RD

  • Pediatric Nutrition Registered Dietitian
  • Charlotte, NC
National Provider Identifier
1396618252
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X
License
L008864 Issued in NC
Practice address
1350 S Kings Dr
Charlotte, NC 28207-2134
Phone
(704) 446-1422
NPI assigned
Sep 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X L008864 NC Primary

Addresses

Primary practice location

1350 S Kings Dr
Charlotte, NC 28207-2134

Mailing address

1350 S Kings Dr
Charlotte, NC 28207-2134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251208003341 NC Practitioner - Registered Dietitian Or Nutrition Professional 7315431335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4435 Golf Acres Dr
Charlotte, NC 28208-5947

PO Box
Suite 19305
Charlotte, NC 28219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L008864NCMDPediatric Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center CurrentSince Oct 10, 2025 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Medical Center CurrentSince Oct 10, 2025 Accepting new patients
Carolinas Medical Center Past Accepting new patients

Locations

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

Organizations & group practices 4

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": "1758844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1396618252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 S KINGS DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S KINGS DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072134",
            "telephone_number": "704-446-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINONES ROSA",
        "first_name": "FABIOLA",
        "middle_name": "NICOHL",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-26",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "NC",
            "license": "L008864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.