Active NPI
Sandra Ruan Wilkes, RD, CSR
- Renal Nutrition Registered Dietitian
- Greenville, NC
National Provider Identifier
1659911626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Renal Nutrition Registered Dietitian
- License
- 86024294
- Practice address
- 1013 Trinity Dr
Greenville, NC 27834-8056 - Phone
- (919) 809-4890
- NPI assigned
- Jan 8, 2020
- Last updated
- Jan 8, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86024294 | NC | |
| Renal Nutrition Registered Dietitian | 133VN1005X | 86024294 | NC | Primary |
Addresses
Primary practice location
1013 Trinity Dr
Greenville, NC 27834-8056
Mailing address
1013 Trinity Dr
Greenville, NC 27834-8056
Phone (919) 809-4890
Other names 1
- Mrs. Sandra Lian Ruan
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86024294 | NC | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sandhills Nutrition LLC | Dietitian, Registered | Current | 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, 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": "1578441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578441600000",
"number": "1659911626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1013 TRINITY DR",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278348056",
"telephone_number": "919-809-4890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1013 TRINITY DR",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278348056",
"telephone_number": "919-809-4890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKES",
"first_name": "SANDRA",
"middle_name": "RUAN",
"name_prefix": "Mrs.",
"credential": "RD, CSR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-08",
"last_updated": "2020-01-08",
"certification_date": "2020-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "86024294",
"primary": false
},
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": "NC",
"license": "86024294",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SANDRA",
"last_name": "RUAN",
"middle_name": "LIAN",
"prefix": "MRS.",
"credential": "RD, CSR",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.