Centralina Council of Governments Area Agency on Aging

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

CENTRALINA COUNCIL OF GOVERNMENTS AREA AGENCY ON AGING

Practice address

9815 David Taylor Dr Ste 100
Charlotte, NC 28262-2358

Phone

(704) 385-4789

Fax

(704) 347-4710

NPI assigned

Aug 2, 2013

Organization subpart

No

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

Authorized official

Name

Geraldine Gardner

Title

Executive Director

Phone

(704) 351-7130

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1375401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635292800000",
    "number": "1841622792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9815 DAVID TAYLOR DR STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282622358",
            "telephone_number": "704-385-4789",
            "fax_number": "704-347-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9815 DAVID TAYLOR DR STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282622358",
            "telephone_number": "704-385-4789",
            "fax_number": "704-347-4710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRALINA COUNCIL OF GOVERNMENTS AREA AGENCY ON AGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-02",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GERALDINE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-351-7130"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14505743",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Charlotte",
            "affiliation": "N",
            "endpointDescription": "Area Agency on Aging",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9815 David Taylor Dr Ste 100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282622358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Central Carolina Medical Clinic, PA (Central Carolina Medical Clinic, PA - Paw Creek Center)
• Central Pediatrics & Internal Medicine, PA
• Centro Medico Latino, PC
• Centrum Medical Group of North Carolina PLLC
• Christina Marie Cerenzia, DO
• Ariel Marion Cerenzie, OD
• Stephanie Cernuto, PA-C

• Registered Dietitian in Charlotte, NC
• Providers in Charlotte, 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 Oct 27, 2021; 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.