Active NPI
Elizabeth Black Smith, RD, LDN
- Registered Dietitian
- Charlotte, NC
National Provider Identifier
1982187571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- L005574
- Practice address
- 5821 Fairview Road
Suite 216
Charlotte, NC 28209 - Phone
- (980) 224-3514
- NPI assigned
- Sep 11, 2018
- Sex
- Female
- Sole proprietor
- No
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 | L005574 | NC | Primary |
Addresses
Primary practice location
5821 Fairview Road
Suite 216
Charlotte, NC 28209
Mailing address
5821 Fairview Road
Suite 216
Charlotte, NC 28209
Phone (980) 224-3514
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 25, 2019 through Jun 25, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L005574 | NC | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charlotte Nutrition LLC | 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": "1536624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550534400000",
"number": "1982187571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5821 FAIRVIEW ROAD",
"address_2": "SUITE 216",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28209",
"telephone_number": "980-224-3514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5821 FAIRVIEW ROAD",
"address_2": "SUITE 216",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28209",
"telephone_number": "980-224-3514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "ELIZABETH",
"middle_name": "BLACK",
"credential": "RD, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-11",
"last_updated": "2019-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L005574",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.