Individual provider Active NPI

Charlotte McIntyre, MS, RD, LDN

  • Sports Dietetics Nutrition Registered Dietitian
  • Fayetteville, AR
National Provider Identifier
1407618523
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Dietetics Nutrition Registered DietitianTaxonomy code 133VN1501X
Practice address
88 E Dunbar LN Apt 311
Fayetteville, AR 72703-3186
Phone
(307) 620-9827
NPI assigned
Jan 24, 2024
Last updated
Jan 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Dietetics Nutrition Registered Dietitian 133VN1501X Primary

Addresses

Primary practice location

88 E Dunbar LN Apt 311
Fayetteville, AR 72703-3186

Mailing address

88 E Dunbar LN Apt 311
Fayetteville, AR 72703-3186
Phone (307) 620-9827

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251014001403 OR Practitioner - Registered Dietitian Or Nutrition Professional 3779070834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10221 Whistle Stop LN Apt
Suite 4207
Frisco, TX 75033-2643

9450 SW Gemini Dr
Beaverton, OR 97008-7105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Strategic Nutrition Multi-Specialty CurrentSince Sep 11, 2025 Accepting new patients
Cloud Health Medical Group of New Jersey, P.C. Multi-Specialty Past Accepting new patients
Mochi Medical Ca PC Multi-Specialty Past Accepting new patients
Cloud Health Medical Group of California, P.C. Multi-Specialty Past Accepting new patients
Cloud Health Medical Group, P.a. Multi-Specialty Past Accepting new patients
Marjorie Nolan Cohn LLC Multi-Specialty Past Accepting new patients

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1407618523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 E DUNBAR LN APT 311",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727033186",
            "telephone_number": "307-620-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 E DUNBAR LN APT 311",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727033186",
            "telephone_number": "307-620-9827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "CHARLOTTE",
        "credential": "MS, RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-24",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; 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.