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NPI Code Detail

MEDICARE: LEXI CHIMERA JOHNSON RD

MEDICARE: LEXI CHIMERA JOHNSON RD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered DietitianL006908NC

General Provider Information

NPI Number : 1912627563
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEXI CHIMERA JOHNSON RD
Provider Business Mailing Address
First Line : PO BOX 1490
Second Line :
City : BOONE
State : NC
Zip : 28607-0682
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 301 E MEETING ST STE 101
Second Line :
City : MORGANTON
State : NC
Zip : 28655-3594
Country : US
Telephone Number : 828-262-3886
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2022
Last Update Date : 01/13/2026

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