Individual provider Active NPI

Rachel Marie Isom, RD

  • Registered Dietitian
  • Charlotte, NC
National Provider Identifier
1871065680
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L005188 Issued in NC
Practice address
1001 Blythe Blvd Ste 500
Charlotte, NC 28203-5863
Phone
(047) 373-1813
NPI assigned
Dec 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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 L005188 NC Primary

Addresses

Primary practice location

1001 Blythe Blvd Ste 500
Charlotte, NC 28203-5863

Mailing address

389 Pamela St
Gastonia, NC 28054-3917
Phone (704) 678-4897

Other practice location 1

14214 Ballantyne Lake Rd Ste 300
Charlotte, NC 28277-3373
Phone (704) 667-2600

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

State licenses

LicenseStateTypeSpecialty
L005188NCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 3, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 3, 2024 Accepting new patients

Locations

1001 Blythe Blvd
Ste 500
Charlotte, NC 28203
Phone (704) 355-5100

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

201 E Grover St
Shelby, NC 28150
Phone (704) 487-3000

Organizations & group practices 3

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": "1545177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1871065680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "389 PAMELA ST",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280543917",
            "telephone_number": "704-678-4897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BLYTHE BLVD STE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035863",
            "telephone_number": "047-373-1813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14214 Ballantyne Lake Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773373",
            "country_code": "US",
            "telephone_number": "704-667-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISOM",
        "first_name": "RACHEL",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-19",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L005188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 26, 2024; 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.