Regan Marie Carroll, MS, RDN, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT88751 Issued in TX

Practice address

3724 Jefferson St Ste 104
Austin, TX 78731-6204

Phone

(512) 692-7045

NPI assigned

Nov 6, 2024

Last updated

Nov 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Group practices

JWF Nutrition LLCGroup PAC ID 2365752979, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• JWF Nutrition, LLC

  • Registered Dietitian
  • Virginia Beach, VA
  • NPI 1356749170

  Dietitian, Registered

  Medicare reassignment Care Compare group NPD
• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1730851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1922821040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 KINGS WAY APT 1221",
            "city": "DEL RIO",
            "state": "TX",
            "postal_code": "788402058",
            "telephone_number": "570-657-6426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3724 JEFFERSON ST STE 104",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316204",
            "telephone_number": "512-692-7045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 Kings Way Apt 1221",
            "address_purpose": "LOCATION",
            "city": "Del Rio",
            "state": "TX",
            "postal_code": "788402058",
            "country_code": "US",
            "telephone_number": "570-657-6426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "REGAN",
        "middle_name": "MARIE",
        "credential": "MS, RDN, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-06",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT88751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynae Carroll, MS, CCC-SLP
• Maurice W. Carroll, LPC
• Miya Danielle Carroll, MS, RD
• Morgan Carroll
• Nicole Carroll, MS, LPC, NCC
• Stephanie Ann Carroll, RPH
• Joanne Frances Carrubba, LCSW
• Abby Carruth
• Jack Charles Carsner, MD
• Amy Jo Carson, LICSW

• Registered Dietitian in Austin, TX
• Providers in Austin, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.