Individual provider Active NPI

Nicole Therese Withrow, RD

  • Registered Dietitian
  • Charlotte, NC
National Provider Identifier
1598270308
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L005475 Issued in NC
Practice address
4525 Cameron Valley Pkwy
Ste 4100
Charlotte, NC 28211-4369
Phone
(704) 302-9462
NPI assigned
Dec 4, 2017
Last updated
Aug 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 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 L005475 NC Primary

Addresses

Primary practice location

4525 Cameron Valley Pkwy
Ste 4100
Charlotte, NC 28211-4369

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

15110 John J Delaney Dr
Ste 200
Charlotte, NC 28277-3544
Phone (704) 302-9462

Other practice location 2

10650 Park Rd
Ste 330
Charlotte, NC 28210-8538
Phone (704) 302-9462

Other practice location 3

13640 Steelecroft Pkwy
Ste 320
Charlotte, NC 28278-7565
Phone (704) 302-9462

Other practice location 4

16455 Statesville Rd
Ste 200
Huntersville, NC 28078-7135
Phone (704) 302-9462

Other names 1

  • Nicole Therese Thelen Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address nthelen2780323@CarolinasHealthcareSystem.direct-ci.com Atrium Health

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231223000101 NC Practitioner - Registered Dietitian Or Nutrition Professional 5395195853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

4525 Cameron Valley Pkwy
Suite 4100
Charlotte, NC 28211-4378
Phone (704) 302-8337

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Nov 12, 2023 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Dietitian, Registered CurrentSince Nov 12, 2023 Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

10650 Park Rd
Ste 330
Charlotte, NC 28210
Phone (704) 468-8877

13640 Steelecroft Pkwy
Ste 320
Charlotte, NC 28278
Phone (704) 302-8900

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

15110 John J Delaney Dr
Ste 200
Charlotte, NC 28277
Phone (704) 302-8100

4525 Cameron Valley Pkwy
Ste 4100
Charlotte, NC 28211
Phone (704) 302-9300

16455 Statesville Rd
Ste 200
Huntersville, NC 28078
Phone (704) 302-8600

Interoperability endpoints

  • Direct secure messaging: nthelen2780323@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 3

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": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1598270308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 CAMERON VALLEY PKWY",
            "address_2": "STE 4100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114369",
            "telephone_number": "704-302-9462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15110 John J Delaney Dr",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773544",
            "country_code": "US",
            "telephone_number": "704-302-9462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10650 Park Rd",
            "address_2": "Ste 330",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108538",
            "country_code": "US",
            "telephone_number": "704-302-9462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13640 Steelecroft Pkwy",
            "address_2": "Ste 320",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282787565",
            "country_code": "US",
            "telephone_number": "704-302-9462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16455 Statesville Rd",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787135",
            "country_code": "US",
            "telephone_number": "704-302-9462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITHROW",
        "first_name": "NICOLE",
        "middle_name": "THERESE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-04",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L005475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nthelen2780323@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "4525 Cameron Valley Pkwy",
            "address_2": "Ste 4100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282114369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "THELEN",
            "middle_name": "THERESE",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 25, 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.