Jacquelyn Chandler Rupp

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

L0030016 Issued in NC

Practice address

2015 Randolph Rd
Suite 208
Charlotte, NC 28207-1128

Phone

(704) 377-4009

NPI assigned

Oct 28, 2013

Last updated

Oct 28, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1382918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382918400000",
    "number": "1508294687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13808 PROFESSIONAL CENTER DR",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787948",
            "telephone_number": "704-377-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 RANDOLPH RD",
            "address_2": "SUITE 208",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071128",
            "telephone_number": "704-377-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPP",
        "first_name": "JACQUELYN",
        "middle_name": "CHANDLER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-28",
        "last_updated": "2013-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L0030016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2013; 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.