Individual provider Active NPI

Sharon L Wallace, RDN

  • Pediatric Nutrition Registered Dietitian
  • Chapel Hill, NC
National Provider Identifier
1659562122
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X
License
L001277 Issued in NC
Practice address
101 Manning Dr
Chapel Hill, NC 27514-4220
Phone
(984) 974-9500
Fax
(984) 215-5811
NPI assigned
Aug 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X L001277 NC Primary

Addresses

Primary practice location

101 Manning Dr
Chapel Hill, NC 27514-4220

Mailing address

211 Friday Center Dr
Suite 2091, Room 2012
Chapel Hill, NC 27517-9499
Phone (919) 966-0420

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071129000371 NC Practitioner - Registered Dietitian Or Nutrition Professional 5496844367 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina Hospitals at Chapel Hill CurrentSince Oct 15, 2019 Accepting new patients
University of North Carolina Hospitals at Chapel Hill Nutrition, Pediatric CurrentSince Oct 15, 2019 Accepting new patients
University of North Carolina Hospitals at Chapel Hill Current Accepting new patients
University of North Carolina Hospitals at Chapel Hill Past Accepting new patients

Locations

211 Friday Center Dr
Ste 2091
Chapel Hill, NC 27517
Phone (984) 974-1183

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1659562122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 FRIDAY CENTER DR",
            "address_2": "SUITE 2091, ROOM 2012",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275179499",
            "telephone_number": "919-966-0420",
            "fax_number": "919-966-9983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MANNING DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144220",
            "telephone_number": "984-974-9500",
            "fax_number": "984-215-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SHARON",
        "middle_name": "L",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "NC",
            "license": "L001277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.