Active NPI
Jennifer Cloos Bean, R.D.
- Registered Dietitian
- Charlotte, NC
National Provider Identifier
1629262209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- L001814CR
- Practice address
- 11220 Elm LN
Suite 102
Charlotte, NC 28277-0715 - Phone
- (704) 995-0442
- NPI assigned
- Aug 28, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | L001814CR | NC | Primary |
Addresses
Primary practice location
11220 Elm LN
Suite 102
Charlotte, NC 28277-0715
Mailing address
8416 Wren Creek Drive
Charlotte, NC 28269
Phone (704) 995-0442
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L001814CR | NC | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Strategic Nutrition | Dietitian, Registered | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188259200000",
"number": "1629262209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8416 WREN CREEK DRIVE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28269",
"telephone_number": "704-995-0442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11220 ELM LN",
"address_2": "SUITE 102",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282770715",
"telephone_number": "704-995-0442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAN",
"first_name": "JENNIFER",
"middle_name": "CLOOS",
"name_prefix": "Mrs.",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-28",
"last_updated": "2007-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L001814CR",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.