Individual provider Active NPI

Jodi Lee Wingrove, RD, LDN

  • Registered Dietitian
  • Charlotte, NC
National Provider Identifier
1881163400
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
848395 Issued in NC
Practice address
2630 E 7TH St
Charlotte, NC 28204-4318
Phone
(704) 355-9484
NPI assigned
Nov 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X L001389 NC
Registered Dietitian 133V00000X 848395 NC Primary

Addresses

Primary practice location

2630 E 7TH St
Charlotte, NC 28204-4318

Mailing address

2630 E 7TH St
Charlotte, NC 28204-4318
Phone (704) 355-9484

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
848395NCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Pinehurst Surgical Clinic PA CurrentSince Jul 25, 2024 Accepting new patients

Locations

5 First Village Dr
Pinehurst, NC 28374
Phone (910) 235-2713

300 Pavilion Way
Southern Pines, NC 28387
Phone (910) 295-0243

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": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1881163400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 E 7TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044318",
            "telephone_number": "704-355-9484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 E 7TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044318",
            "telephone_number": "704-355-9484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINGROVE",
        "first_name": "JODI",
        "middle_name": "LEE",
        "credential": "RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-14",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L001389",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "848395",
            "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 Nov 14, 2018; 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.