Organization Active NPI

Life Resources of NC

  • Registered Dietitian
  • Raleigh, NC
National Provider Identifier
1457782104
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
976161 Issued in NC
Legal business name
LIFE RESOURCES OF NC
Practice address
183 Wind Chime CT
Suite 100
Raleigh, NC 27615-6461
Phone
(919) 896-8520
Fax
(919) 896-8534
NPI assigned
Dec 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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

Authorized official

Name
Mrs. Tasha R. Gaskins, MSW,MPA
Title
Ceo
Phone
(919) 896-8520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X 976161 NC Primary

Addresses

Primary practice location

183 Wind Chime CT
Suite 100
Raleigh, NC 27615-6461

Mailing address

183 Wind Chime CT
Suite 100
Raleigh, NC 27615-6461
Phone (919) 896-8520

Other identifiers 1

IdentifierTypeStateIssuer
1518393586MedicaidNC

National Provider Directory

National Provider Directory

Locations

183 Wind Chime Ct
Ste 100
Raleigh, NC 27615
Phone (919) 896-8520

NPI Registry JSON

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395792000000",
    "number": "1457782104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 WIND CHIME CT",
            "address_2": "SUITE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276156461",
            "telephone_number": "919-896-8520",
            "fax_number": "919-896-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 WIND CHIME CT",
            "address_2": "SUITE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276156461",
            "telephone_number": "919-896-8520",
            "fax_number": "919-896-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE RESOURCES OF NC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-06",
        "last_updated": "2014-03-26",
        "status": "A",
        "authorized_official_last_name": "GASKINS",
        "authorized_official_first_name": "TASHA",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-896-8520",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW,MPA"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "976161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518393586",
            "state": "NC"
        }
    ],
    "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 Mar 26, 2014; 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.