Jeanne A Doherty, MS, RDN, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

L006167 Issued in NC

Practice address

730 Highland Oaks Dr
Winston Salem, NC 27103-7154

Phone

(336) 646-7323

Fax

(336) 646-7787

NPI assigned

Sep 4, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC, IL2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Myndfl

  • Mental Health Counselor
  • Northbrook, IL
  • NPI 1932948619
  Medicare reassignment NPD
• Myndfl Medical PLLC

  • Internal Medicine Physician
  • Northbrook, IL
  • NPI 1356232235
  Medicare reassignment NPD
• Nutrition Care of the Piedmont LLC

  • Registered Dietitian
  • Winston Salem, NC
  • NPI 1184322687

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1689288847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604050",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282604050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 HIGHLAND OAKS DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271037154",
            "telephone_number": "336-646-7323",
            "fax_number": "336-646-7787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Pineview Dr Ste 205",
            "address_purpose": "LOCATION",
            "city": "Kernersville",
            "state": "NC",
            "postal_code": "272843814",
            "country_code": "US",
            "telephone_number": "336-329-3295",
            "fax_number": "336-355-5204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "JEANNE",
        "middle_name": "A",
        "credential": "MS, RDN, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-04",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L006167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdoherty841646@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "730 Highland Oaks Dr",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271037154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica F. Doerrler, PA-C
• Dogwood FCH
• Alexandra Doherty
• Ann Doherty, LPC
• Brittany Doherty, MS, CCC-SLP
• Sean Patrick Doherty, MD
• Timothy Michael Doherty, LCSW
• Emily Lauren Dohoney, RD, LDN
• Matthew Dollyhite, BOCO
• Allison Dombroski, MD

• Registered Dietitian in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; 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.