Individual provider Active NPI

Lauren Elizabeth McIlwaine, MSC, MPH, RD, LDN

  • Registered Dietitian
  • Raleigh, NC
National Provider Identifier
1467013631
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L005141 Issued in NC
Practice address
1042 Washington St
Raleigh, NC 27605-1258
Phone
(919) 781-4500
Fax
(919) 781-4504
NPI assigned
Jun 27, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X L005141 NC Primary

Addresses

Primary practice location

1042 Washington St
Raleigh, NC 27605-1258

Mailing address

1042 Washington St
Raleigh, NC 27605-1258
Phone (919) 781-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 27, 2019 through Jun 27, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L005141NCMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1467013631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1042 WASHINGTON ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051258",
            "telephone_number": "919-781-4500",
            "fax_number": "919-781-4504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1042 WASHINGTON ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051258",
            "telephone_number": "919-781-4500",
            "fax_number": "919-781-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCILWAINE",
        "first_name": "LAUREN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "MSC, MPH, RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L005141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.