Active NPI
Jessica Green, RD
- Registered Dietitian
- Wake Forest, NC
National Provider Identifier
1972976223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- L002312
- Practice address
- 1424 Freshwater CT
Wake Forest, NC 27587-6262 - Phone
- (919) 332-3722
- NPI assigned
- Nov 9, 2015
- 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 | L002312 | NC | Primary |
Addresses
Primary practice location
1424 Freshwater CT
Wake Forest, NC 27587-6262
Mailing address
1424 Freshwater CT
Wake Forest, NC 27587-6262
Phone (919) 332-3722
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447027200000",
"number": "1972976223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1424 FRESHWATER CT",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275876262",
"telephone_number": "919-332-3722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1424 FRESHWATER CT",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275876262",
"telephone_number": "919-332-3722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "JESSICA",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-11-09",
"last_updated": "2015-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L002312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wake Forest, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.