Healthcare Provider Details

I. General information

NPI: 1508684895
Provider Name (Legal Business Name): CAITLYN JILLIAN ROUNTREE MS, RD, LDN, CNSC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2024
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 DUKE MEDICINE CIRCLE ROOM 015, PURPLE ZONE
DURHAM NC
27710
US

IV. Provider business mailing address

5507 NUR LN
RALEIGH NC
27606-4048
US

V. Phone/Fax

Practice location:
  • Phone: 919-681-6061
  • Fax:
Mailing address:
  • Phone: 603-303-4330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL008071
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: