Individual provider Active NPI

Chelsie Azevedo, RD

  • Registered Dietitian
  • Durham, NC
National Provider Identifier
1891511523
Registry record updated Dec 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L008332 Issued in NC
Practice address
1315 Ripley St Apt B
Durham, NC 27707-1182
Phone
(984) 810-6185
NPI assigned
Nov 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 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 L008332 NC Primary

Addresses

Primary practice location

1315 Ripley St Apt B
Durham, NC 27707-1182

Mailing address

1315 Ripley St Apt B
Durham, NC 27707-1182
Phone (984) 810-6185

Other names 1

  • Chelsie Kolberg Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L008332NCMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733011200000",
    "number": "1891511523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 RIPLEY ST APT B",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277071182",
            "telephone_number": "984-810-6185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 RIPLEY ST APT B",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277071182",
            "telephone_number": "984-810-6185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZEVEDO",
        "first_name": "CHELSIE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-26",
        "last_updated": "2024-12-01",
        "certification_date": "2024-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L008332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHELSIE",
            "last_name": "KOLBERG",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.