Individual provider Active NPI

Jack Varnon, RDN

  • Registered Dietitian
  • Fayetteville, NC
National Provider Identifier
1578414942
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
2153 Valleygate Dr Ste 202
Fayetteville, NC 28304-3667
Phone
(910) 399-6552
NPI assigned
Feb 3, 2026
Last updated
Feb 3, 2026By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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 NU Primary

Addresses

Primary practice location

2153 Valleygate Dr Ste 202
Fayetteville, NC 28304-3667

Mailing address

2517 Delaney Ave
Wilmington, NC 28403-6003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260219002259 NC Practitioner - Registered Dietitian Or Nutrition Professional 6709366586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nutrition in MotionGroup PAC ID 8123281938, 16 clinicians

Practice addresses (Care Compare)

20 Medical Campus Dr NW
Suite 206
Supply, NC 28462-4094
Phone (910) 239-3562

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrition in Motion Dietitian, Registered CurrentSince Feb 9, 2026 Accepting new patients

Locations

2153 Valleygate Dr
Ste 202
Fayetteville, NC 28304
Phone (910) 399-6552

20 Medical Campus Dr NW
Ste 206
Supply, NC 28462
Phone (910) 754-5453

2517 Delaney Ave
Wilmington, NC 28403
Phone (910) 667-9417

Organizations & group practices 1

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": "1770076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1578414942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2517 DELANEY AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2153 VALLEYGATE DR STE 202",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043667",
            "telephone_number": "910-399-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARNON",
        "first_name": "JACK",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-02-03",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; 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.