Individual provider Active NPI

Basheerah Enahora, RDN, LDN

  • Registered Dietitian
  • Charlotte, NC
National Provider Identifier
1669924767
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L004831 Issued in NC
Practice address
4651 Charlotte Park Dr Ste 101C
Charlotte, NC 28217-1916
Phone
(704) 380-9924
NPI assigned
Oct 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X L004831 NC
Registered Dietitian 133V00000X L004831 NC Primary

Addresses

Primary practice location

4651 Charlotte Park Dr Ste 101C
Charlotte, NC 28217-1916

Mailing address

4651 Charlotte Park Dr Ste 101C
Charlotte, NC 28217-1916
Phone (704) 380-9924

Other practice location 1

4614 Country Club Rd
Weight Management Center
Winston Salem, NC 27104-3520
Phone (336) 716-6382

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

Practice roles

OrganizationSpecialtyStatusNew patients
Be Nutrition LLC Nutrition, Metabolic CurrentSince Sep 29, 2019 Accepting new patients

Locations

4651 Charlotte Park Dr
Ste 101C
Charlotte, NC 28217
Phone (704) 251-5146

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": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1669924767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 CHARLOTTE PARK DR STE 101C",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282171916",
            "telephone_number": "704-380-9924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4651 CHARLOTTE PARK DR STE 101C",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282171916",
            "telephone_number": "704-380-9924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4614 Country Club Rd",
            "address_2": "Weight Management Center",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271043520",
            "country_code": "US",
            "telephone_number": "336-716-6382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENAHORA",
        "first_name": "BASHEERAH",
        "name_prefix": "Ms.",
        "credential": "RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-25",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "NC",
            "license": "L004831",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L004831",
            "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 Sep 11, 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.