CALLAN E WALL


Address: 5405 Carolyn Dr, Wilmington, NC 28409-5913
Phone: 9192448234

CALLAN E WALL (NPI# 1932585957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1932585957
Entity Type Individual
Full Name CALLAN E WALL
Credential RD, LDN
Practice Address 5405 Carolyn Dr
Wilmington
NC 28409-5913
Mailing Address 1505 Medical Center Dr
Wilmington
NC 28401-7507
Practice Telephone 9192448234
Practice Fax Number 8778892993
Mailing Telephone 9102393562
Mailing Fax Number 8778892993
Enumeration Date 2015-07-31
Last Update Date 2020-09-09
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 133V00000X Dietitian, Registered Dietary & Nutritional Service Providers
Y 133V00000X Dietitian, Registered L004679 NC Dietary & Nutritional Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
CDR 86056016 01

Office Location

Street Address 5405 CAROLYN DR
City WILMINGTON
State NC
Zip Code 28409-5913

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1952916728 Emily Savannah Holland Specialist/Technologist 1150 King's Hwy, Wilmington, NC 28409 2020-09-09
1912373465 Thomas Malenfant Hearing Instrument Specialist 474 New Centre Drive, #6, Wilmington, NC 28409 2015-08-19
1720482862 Leslie Morton Garris Pharmacist 6013 Chancellorville Drive, Wilmington, NC 28409 2014-10-17
1659621720 Charles Warren Moorehead Social Worker 5710 Oleander Dr. Suite 208, Wilmington, NC 28409 2012-09-14
1992972020 Nancy Beth Kotz Social Worker 6211 Terrapin Ct, Wilmington, NC 28409 2008-05-08
1366611089 Michael Royce Penland Psychologist 5002-1 Hewletts Run, Wilmington, NC 28409 2008-02-27
1184755092 Keith W Mann Dentist 818-101 Pine Grove Drive, Wilmington, NC 28409 2007-03-09
1477650554 Jeffrey Beecham Chick Specialist 1201 Porches Dr, Suite 2, Wilmington, NC 28409 2006-09-20
1407964067 Richard A. Lally Counselor 5425 Golden Eagle Court, Wilmington, NC 28409 2006-08-25
1598290520 Monaca Lachman Counselor 6020 Leeward Ln, Wilmington, NC 28409-0129 2017-04-27
Find all providers in zip 28409

Taxonomy Information

Taxonomy Code 133V00000X
Grouping Dietary & Nutritional Service Providers
Classification Dietitian, Registered

Taxonomy Definition

A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration.
Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1659978245 Jaclyn Lee Atwater Dietitian, Registered 415 Yucca Ln, Wilmington, NC 28412-1042 2020-10-06
1912521626 Kenneth Jefferson Allen IIi Dietitian, Registered 2106 Barnett Ave, Wilmington, NC 28403-2240 2020-05-29
1720600729 Melissa Buscetta Dietitian, Registered 4647 Fairview Dr Apt 328, Wilmington, NC 28412-3684 2020-05-12
1285270207 Ruby Ali Dietitian, Registered 115 Amberleigh Dr Apt 206, Wilmington, NC 28411-9810 2019-11-25
1184280158 Melissa Danielle Flynn Dietitian, Registered 4702 Bentley Dr, Wilmington, NC 28409-6958 2019-05-15
1013424126 Kyrstin Brianna Draney Dietitian, Registered 5129 Oleander Dr Ste 103, Wilmington, NC 28403-7062 2018-01-10
1588191225 Rachael Swartz Dietitian, Registered 3305 Burnt Mill Dr Ste 100, Wilmington, NC 28403-3067 2017-05-12
1235663014 April Callahan Dietitian, Registered 2 Kristina Ct, Wilmington, DE 19808-4063 2017-04-18
1518416205 Nancy Lois Angell Dietitian, Registered 114 Kenneth Ct, Wilmington, NC 28405-1307 2016-09-23
1891163218 Stefanie Weiner Dietitian, Registered 919 Cloister Rd, Apt E, Wilmington, DE 19809-1018 2015-09-02
Find all providers in WILMINGTON

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City WILMINGTON
Zip Code 28409

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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