Active NPI
Whitney Russell, RD
- Registered Dietitian
- Jacksonville, NC
National Provider Identifier
1972156552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86024460
- Practice address
- 413 Little Creek CT
Jacksonville, NC 28546-8737 - Phone
- (757) 869-4255
- NPI assigned
- Jul 22, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86024460 | Primary |
Addresses
Primary practice location
413 Little Creek CT
Jacksonville, NC 28546-8737
Mailing address
413 Little Creek CT
Jacksonville, NC 28546-8737
Phone (757) 869-4255
Other practice location 1
612 College St
Jacksonville, NC 28540-5311
Phone (757) 869-4255
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish to Honor | Dietitian, Registered | Past | Accepting new patients |
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": "1563753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563753600000",
"number": "1972156552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "413 LITTLE CREEK CT",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285468737",
"telephone_number": "757-869-4255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "413 LITTLE CREEK CT",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285468737",
"telephone_number": "757-869-4255"
}
],
"practiceLocations": [
{
"address_1": "612 College St",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "NC",
"postal_code": "285405311",
"country_code": "US",
"telephone_number": "757-869-4255",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUSSELL",
"first_name": "WHITNEY",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-22",
"last_updated": "2019-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "86024460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.