NPIMap

Individual provider Active NPI

Regina Ann Gordon, RD, LDN

  • Registered Dietitian
  • Winston Salem, NC
National Provider Identifier
1821358326
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L001243 Issued in NC
Practice address
1901 S Hawthorne Rd
Suite 360
Winston Salem, NC 27103-3921
Phone
(336) 718-5746
Fax
(336) 718-6190
NPI assigned
May 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X L001243 NC Primary

Addresses

Primary practice location

1901 S Hawthorne Rd
Suite 360
Winston Salem, NC 27103-3921

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 718-5746

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
Novant Medical Group, Inc. Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1337299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1821358326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-718-5746",
            "fax_number": "336-718-6190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S HAWTHORNE RD",
            "address_2": "SUITE 360",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033921",
            "telephone_number": "336-718-5746",
            "fax_number": "336-718-6190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "REGINA",
        "middle_name": "ANN",
        "credential": "RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-18",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L001243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; 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.