Organization Active NPI

Thrive Nutrition

  • Registered Dietitian
  • Gaithersburg, MD
National Provider Identifier
1104395953
Registry record updated Mar 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
THRIVE NUTRITION
Practice address
16567 Sioux LN
Gaithersburg, MD 20878-2048
Phone
(240) 780-8135
NPI assigned
Nov 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2025

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

Authorized official

Name
Astrida Awa Teneng, CDCES, RDNPI 1528319738
Title
Registered Dietitian
Phone
(240) 780-8135

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X Primary
Pediatric Nutrition Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133VN1004X
Metabolic Nutrition Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133VN1006X

Addresses

Primary practice location

16567 Sioux LN
Gaithersburg, MD 20878-2048

Mailing address

16567 Sioux LN
Gaithersburg, MD 20878-2048
Phone (502) 303-7705

Other practice location 1

3804 Cannon Point Dr
Chesapeake, VA 23321-5703
Phone (502) 303-7705

Other practice location 2

9711 Washingtonian Blvd Ste 550
Gaithersburg, MD 20878-5789
Phone (502) 303-7705

Other identifiers 1

IdentifierTypeStateIssuer
12585463OtherCAQH

Other names 2

  • Thrive Nutrition Doing business as
  • Diathrive Nutrition Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250218002079 DC Part B Supplier - Clinic/Group Practice 7214364645 Receives reassigned benefits from 1 practitioner
Practice locations: Gaithersburg, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741478400000",
    "number": "1104395953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16567 SIOUX LN",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208782048",
            "telephone_number": "502-303-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16567 SIOUX LN",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208782048",
            "telephone_number": "240-780-8135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3804 Cannon Point Dr",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233215703",
            "country_code": "US",
            "telephone_number": "502-303-7705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9711 Washingtonian Blvd Ste 550",
            "address_purpose": "LOCATION",
            "city": "Gaithersburg",
            "state": "MD",
            "postal_code": "208785789",
            "country_code": "US",
            "telephone_number": "502-303-7705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THRIVE NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-21",
        "last_updated": "2025-03-09",
        "certification_date": "2025-03-09",
        "status": "A",
        "authorized_official_last_name": "TENENG",
        "authorized_official_first_name": "ASTRIDA",
        "authorized_official_middle_name": "AWA",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "240-780-8135",
        "authorized_official_credential": "CDCES, RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12585463",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thrive Nutrition",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Diathrive Nutrition",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.