Individual provider Active NPI

Kerry Barbera, RDN

  • Registered Dietitian
  • Charlotte, NC
National Provider Identifier
1770038325
Registry record updated Jan 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L004955 Issued in NC
Practice address
12421 Belmont Mansion Dr
Charlotte, NC 28273
Phone
(704) 806-9914
NPI assigned
Aug 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1537 SC
Registered Dietitian 133V00000X L004955 NC Primary

Addresses

Primary practice location

12421 Belmont Mansion Dr
Charlotte, NC 28273

Mailing address

12421 Belmont Mansion Dr
Charlotte, NC 28273-0056
Phone (704) 806-9914

Other practice location 1

15420 Superior St
Charlotte, NC 28273-6809
Phone (704) 806-9914

Other practice location 2

15420 Superior St
Charlotte, NC 28273-6809
Phone (704) 806-9914

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

LicenseStateTypeSpecialty
L004955NCMDRegistered Dietitian
1537SCMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548547200000",
    "number": "1770038325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12421 BELMONT MANSION DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282730056",
            "telephone_number": "704-806-9914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12421 BELMONT MANSION DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28273",
            "telephone_number": "704-806-9914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15420 Superior St",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282736809",
            "country_code": "US",
            "telephone_number": "704-806-9914",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15420 Superior St",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282736809",
            "country_code": "US",
            "telephone_number": "704-806-9914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARBERA",
        "first_name": "KERRY",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-23",
        "last_updated": "2019-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SC",
            "license": "1537",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L004955",
            "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 Jan 27, 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.