NPIMap

Organization Active NPI

Total Nutrition Technology, Inc.

  • Registered Dietitian
  • Charlotte, NC
National Provider Identifier
1467599001
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
TOTAL NUTRITION TECHNOLOGY, INC.
Practice address
10400 Mallard Creek Rd Ste 340
Charlotte, NC 28262-5203
Phone
(704) 549-9550
Fax
(704) 549-9570
NPI assigned
Jan 31, 2007
Last updated
Aug 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Authorized official

Name
Vanessa Lara, PHD, CNS, LDN/LNNPI 1558770800
Title
Cso
Phone
(704) 549-9550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X NU
Registered Dietitian 133V00000X NU Primary
Pediatric Nutrition Registered Dietitian 133VN1004X NU
Metabolic Nutrition Registered Dietitian 133VN1006X NU
Registered Dietetic Technician 136A00000X NU

Addresses

Primary practice location

10400 Mallard Creek Rd Ste 340
Charlotte, NC 28262-5203

Mailing address

10400 Mallard Creek Rd Ste 340
Charlotte, NC 28262-5203
Phone (704) 549-9550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220427002759 NC Part B Supplier - Clinic/Group Practice 0941697643 Receives reassigned benefits from 4 practitioners
Practice locations: Cornelius, NC; Charlotte, NC

National Provider Directory

National Provider Directory

Locations

10400 Mallard Creek Rd
Ste 340
Charlotte, NC 28262
Phone (704) 549-9550

10643 Kettering Dr
Ste 101
Charlotte, NC 28226
Phone (704) 549-9550

11301 Carmel Commons Blvd
Ste 108
Charlotte, NC 28226
Phone (704) 549-9550

507 Providence Rd
Charlotte, NC 28207
Phone (704) 549-9550

18137 W Catawba Ave
Ste 6
Cornelius, NC 28031
Phone (704) 549-9550

Practitioners & affiliated clinicians

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787788800000",
    "number": "1467599001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10400 MALLARD CREEK RD STE 340",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282625203",
            "telephone_number": "704-549-9550",
            "fax_number": "704-549-9570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 MALLARD CREEK RD STE 340",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282625203",
            "telephone_number": "704-549-9550",
            "fax_number": "704-549-9570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL NUTRITION TECHNOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A",
        "authorized_official_last_name": "LARA",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "CSO",
        "authorized_official_telephone_number": "704-549-9550",
        "authorized_official_credential": "PHD, CNS, LDN/LN"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "136A00000X",
            "taxonomy_group": "",
            "desc": "Dietetic Technician, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.