Individual provider Active NPI

Sydney Amidon Hinshaw

  • Registered Dietitian
  • Raleigh, NC
National Provider Identifier
1962230664
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L007962 Issued in NC
Practice address
23 Sunnybrook Rd
Raleigh, NC 27610-1855
Phone
(919) 350-8000
NPI assigned
Jul 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 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 L007962 NC Primary

Addresses

Primary practice location

23 Sunnybrook Rd
Raleigh, NC 27610-1855

Mailing address

104 Medspring Dr Ste 210
Clayton, NC 27520-9687

Other practice location 1

104 Medspring Dr Ste 210
Clayton, NC 27520-9687
Phone (919) 350-4201

Other practice location 2

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-9500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241015001232 NC Practitioner - Registered Dietitian Or Nutrition Professional 7214469352 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L007962NCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group, LLC CurrentSince Aug 26, 2024 Accepting new patients
Wakemed Specialists Group, LLC Current Accepting new patients
Wakemed Specialists Group LLC CurrentSince Aug 26, 2024 Accepting new patients
Wakemed PastSince Jul 28, 2024 Accepting new patients

Locations

120 Healthplex Way
Apex, NC 27502
Phone (919) 235-6525

104 Medspring Dr
#210
Clayton, NC 27520
Phone (919) 350-4201

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

23 Sunnybrook Rd
Raleigh, NC 27610
Phone (919) 322-4800

Organizations & group practices 4

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": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1962230664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 MEDSPRING DR STE 210",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275209687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 SUNNYBROOK RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101855",
            "telephone_number": "919-350-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Medspring Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "Clayton",
            "state": "NC",
            "postal_code": "275209687",
            "country_code": "US",
            "telephone_number": "919-350-4201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3000 New Bern Ave",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276101231",
            "country_code": "US",
            "telephone_number": "919-350-9500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HINSHAW",
        "first_name": "SYDNEY",
        "middle_name": "AMIDON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L007962",
            "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 Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.