Individual provider Active NPI

Heather Renee Cupp, R.D.

  • Registered Dietitian
  • Raleigh, NC
National Provider Identifier
1932185378
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L006978 Issued in NC
Practice address
2930 Forestville Rd
Raleigh, NC 27616-8774
Phone
(919) 235-6550
NPI assigned
Dec 19, 2005
Last updated
Oct 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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 NU
Registered Dietitian 133V00000X L006978 NC Primary

Addresses

Primary practice location

2930 Forestville Rd
Raleigh, NC 27616-8774

Mailing address

PO Box 602195
Charlotte, NC 28260-2195
Phone (877) 498-4490

Other practice location 1

3350 La Jolla Village Dr
San Diego, CA 92161-0002
Phone (858) 552-8585 ext. 3373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220923001732 NC Practitioner - Registered Dietitian Or Nutrition Professional 4789069923 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wakemed Specialists Group LLCGroup PAC ID 2466788377, 868 clinicians
Wake Specialty Physicians LLCGroup PAC ID 7416006085, 178 clinicians

Practice addresses (Care Compare)

210 Ashville Ave
Cary, NC 27518-6600
Phone (919) 350-2800

2930 Forestville Rd
Raleigh, NC 27616-8774
Phone (919) 235-6550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group, LLC CurrentSince Jun 13, 2023 Accepting new patients
Wakemed Specialists Group LLC CurrentSince Jun 13, 2023 Accepting new patients
Wake Specialty Physicians LLC CurrentSince Jun 13, 2023 Accepting new patients
Wake Specialty Physicians LLC CurrentSince Jun 13, 2023 Accepting new patients
Wakemed Specialists Group, LLC Current Accepting new patients
Wake Specialty Physicians, LLC Current Accepting new patients

Locations

210 Ashville Ave
Cary, NC 27518
Phone (919) 235-6460

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

2930 Forestville Rd
Raleigh, NC 27616
Phone (919) 235-6500

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1932185378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602195",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602195",
            "telephone_number": "877-498-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 FORESTVILLE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276168774",
            "telephone_number": "919-235-6550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3350 La Jolla Village Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921610002",
            "country_code": "US",
            "telephone_number": "858-552-8585 x3373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUPP",
        "first_name": "HEATHER",
        "middle_name": "RENEE",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L006978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.