Active NPI
Jessica Davidson, MPH, RD, LDN.
- Registered Dietitian
- Raleigh, NC
National Provider Identifier
1831926476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 1520 Sunday Dr Ste 309
Raleigh, NC 27607-5254 - Phone
- (919) 354-7077
- NPI assigned
- Sep 17, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
1520 Sunday Dr Ste 309
Raleigh, NC 27607-5254
Mailing address
4530 Hargrove Rd Apt 201
Raleigh, NC 27604-2868
Phone (910) 641-2665
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | info@lifestylemedicalcenters.com | RTP Healthy Wellness, PLLC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241030002670 | NC | Practitioner - Registered Dietitian Or Nutrition Professional | 5799218657 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726531200000",
"number": "1831926476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4530 HARGROVE RD APT 201",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276042868",
"telephone_number": "910-641-2665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1520 SUNDAY DR STE 309",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276075254",
"telephone_number": "919-354-7077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "JESSICA",
"credential": "MPH, RD, LDN.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-17",
"last_updated": "2024-09-17",
"certification_date": "2024-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "info@lifestylemedicalcenters.com",
"affiliation": "Y",
"affiliationName": "RTP Healthy Wellness, PLLC",
"address_1": "1520 Sunday Dr Ste 309",
"city": "Raleigh",
"state": "NC",
"country_code": "US",
"postal_code": "276075254",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.