Active NPI
Cynthia Libby, MS, RD, LDN, CEDS
- Registered Dietitian
- Vienna, VA
National Provider Identifier
1093599045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.007138
- Practice address
- 410 Pine St SE Ste 150
Vienna, VA 22180-4877 - Phone
- (703) 259-8500
- NPI assigned
- Aug 22, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164.007138 | IL | Primary |
Addresses
Primary practice location
410 Pine St SE Ste 150
Vienna, VA 22180-4877
Mailing address
15705 Old Orchard CT Unit 2S
Orland Park, IL 60462-3569
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.007138 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693008000000",
"number": "1093599045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15705 OLD ORCHARD CT UNIT 2S",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604623569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 PINE ST SE STE 150",
"city": "VIENNA",
"state": "VA",
"postal_code": "221804877",
"telephone_number": "703-259-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIBBY",
"first_name": "CYNTHIA",
"credential": "MS, RD, LDN, CEDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-22",
"last_updated": "2023-08-26",
"certification_date": "2023-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.007138",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vienna, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.