Joanna Pustilnik, MS RDN LDN CDCES

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1032609

Practice address

2134 S Nelson St
Arlington, VA 22204-5410

Phone

(804) 787-4431

NPI assigned

Mar 25, 2017

Last updated

Dec 11, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Joanna Morris Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2022 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bodacious Nutrition LLC

  dba Joanna Pustilnik

  • Registered Dietitian
  • Arlington, VA
  • NPI 1124895024

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1490400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1053842518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2134 S NELSON ST",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222045410",
            "telephone_number": "804-787-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2134 S NELSON ST",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222045410",
            "telephone_number": "804-787-4431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUSTILNIK",
        "first_name": "JOANNA",
        "name_prefix": "Mrs.",
        "credential": "MS RDN LDN CDCES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-25",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "1032609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANNA",
            "last_name": "MORRIS",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kimberly Ann Prosser, NP
• Irene Teresa Paz Pruitt, M.S., LPC
• Alvaro Andres Puig Rodriguez, M.D
• Ayanna Maia Pulley, L.C.S.W.
• Rajesh Puri, M.D., FAAP, FACPH
• Sashi Putchakayala, M.D.
• Lu Qiu
• Kaylin P Quach, PHARMD
• Quality Healthcare Services Inc
• Quality Healthcare Services, Inc.

• Registered Dietitian in Arlington, VA
• Providers in Arlington, VA by specialty
• Registered Dietitian in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.

Verify at the official NPI Registry.