Shenna Yvonne Graham, RDN, LMBT

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

L002360 Issued in NC

Practice address

8731 Brampton Drive
Charlotte, NC 28215

Phone

(704) 806-7510

NPI assigned

Mar 2, 2009

Reactivated

Jul 13, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

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": "1235952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1619117876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8731 BRAMPTON DRIVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28215",
            "telephone_number": "704-806-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8731 BRAMPTON DRIVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28215",
            "telephone_number": "704-806-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "SHENNA",
        "middle_name": "YVONNE",
        "name_prefix": "Miss",
        "credential": "RDN, LMBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-02",
        "last_updated": "2019-06-20",
        "deactivation_date": "2012-03-12",
        "reactivation_date": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NC",
            "license": "L002360",
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NC",
            "license": "L002360",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NC",
            "license": "06188",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L002360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Graham, CNA2
• Rosalba Mendoza Graham
• Shacoya Graham, MA, LMFT, LCAS-A
• Shatina Graham
• Shekinah Graham, PHARMD
• Stephanie Graham, L.P.C.
• Taqueena Z Graham, OTRL
• Taylor Michelle Graham
• Tiffany Michelle Graham, MA, LCMHC-A, LCAS-A
• Timothy Ashley Graham, LCAS-A

• 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 Jun 20, 2019; 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.