Prakasam Annamalai, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2389 Issued in SC

Practice address

10919 Bennett Dr
Davidson, NC 28036-7657

Phone

(843) 452-0281

NPI assigned

Oct 7, 2022

Last updated

Oct 7, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1665100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1841915253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10919 BENNETT DR",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280367657",
            "telephone_number": "843-452-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10919 BENNETT DR",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280367657",
            "telephone_number": "843-452-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANNAMALAI",
        "first_name": "PRAKASAM",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-07",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SC",
            "license": "2389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Allred, MPH, RD, CSSD, LDN
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• Amanda Anderson, LCSW
• Scott Michael Applegate, A.T.C.
• Jessica Thuy-Mai Arnett, PA-C
• Melissa D Arrington, PHARMD
• Yordan Ascanio
• Audrey Nicole Atkinson, PSYD

• Registered Dietitian in Davidson, NC
• Providers in Davidson, 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 7, 2022; 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.