Parker Wallace McKinnon, R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT88010 Issued in TX

Practice address

800 Hartford Ave
Charlotte, NC 28209-2304

Phone

(210) 394-7661

NPI assigned

Apr 4, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Parker Wallace Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• PWM Nutrition LLC

  • Registered Dietitian
  • Raleigh, NC
  • NPI 1023964392

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1992400352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 HARTFORD AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092304",
            "telephone_number": "210-394-7661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 HARTFORD AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092304",
            "telephone_number": "210-394-7661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNON",
        "first_name": "PARKER",
        "middle_name": "WALLACE",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-04",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L008750",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT88010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PARKER",
            "last_name": "WALLACE",
            "credential": "R.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Allie Frank McKinley I
• Dana McKinnely, FNP
• Brandy McKinney
• Karen McKinney
• Patricia McKinney
• Samantha Sage McKinnon
• Alexandra Riehm McKinsey, P.A.
• Robert L McKinstry
• Haley Marie McKissack, MD
• Kamilah McPhail McKissick, PSY.D.

• Registered Dietitian in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.