Individual provider Active NPI

Kathleen Marie Varner, RD LDN

  • Registered Dietitian
  • Charlotte, NC
National Provider Identifier
1780848416
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
507570
Practice address
4700 Cotton Creek Drive
Charlotte, NC 28226
Phone
(704) 341-7926
Fax
(704) 341-7926
NPI assigned
Jul 11, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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 507570 Primary
Registered Dietitian 133V00000X L001589 NC

Addresses

Primary practice location

4700 Cotton Creek Drive
Charlotte, NC 28226

Mailing address

4700 Cotton Creek Drive
Charlotte, NC 28226
Phone (704) 341-7926

Other identifiers 1

IdentifierTypeStateIssuer
141P1OtherBC BS PROVIDER NUMBER

Other names 1

  • Miss Kathleen Marie Ross Former name

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
L001589NCMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215734400000",
    "number": "1780848416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 COTTON CREEK DRIVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28226",
            "telephone_number": "704-341-7926",
            "fax_number": "704-341-7926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 COTTON CREEK DRIVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28226",
            "telephone_number": "704-341-7926",
            "fax_number": "704-341-7926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARNER",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RD LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-11",
        "last_updated": "2008-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "507570",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L001589",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS PROVIDER NUMBER",
            "identifier": "141P1",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "ROSS",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jul 11, 2008; 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.