Individual provider Active NPI

Shania Nage Medeus

  • Registered Dietitian
  • Kernersville, NC
National Provider Identifier
1619842473
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L008921 Issued in NC
Practice address
1730 Kernersville Medical Pkwy Ste 101
Kernersville, NC 27284-7198
Phone
(336) 564-4950
NPI assigned
Oct 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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 L008921 NC Primary

Addresses

Primary practice location

1730 Kernersville Medical Pkwy Ste 101
Kernersville, NC 27284-7198

Mailing address

1730 Kernersville Medical Pkwy
Kernersville, NC 27284-7197
Phone (336) 564-4950

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251114001192 NC Practitioner - Registered Dietitian Or Nutrition Professional 9234620527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

648 Almondridge Dr
Rural Hall, NC 27045-9887
Phone (336) 277-1717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L008921NCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Oct 3, 2025 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Oct 3, 2025 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

3515 W Market St
Ste 310
Greensboro, NC 27403
Phone (336) 718-1970

1730 Kernersville Medical Pkwy
Ste 101
Kernersville, NC 27284
Phone (336) 564-4950

648 Almondridge Dr
Rural Hall, NC 27045
Phone (336) 969-0510

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1759968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1619842473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 KERNERSVILLE MEDICAL PKWY",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847197",
            "telephone_number": "336-564-4950",
            "fax_number": "336-564-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 KERNERSVILLE MEDICAL PKWY STE 101",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847198",
            "telephone_number": "336-564-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDEUS",
        "first_name": "SHANIA",
        "middle_name": "NAGE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-09",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L008921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.