Active NPI
Shannon Piccolo, RD
- Registered Dietitian
- Alexandria, VA
National Provider Identifier
1104628528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DI200001674
- Practice address
- 3001 Park Center Dr Apt 409
Alexandria, VA 22302-1440 - Phone
- (717) 422-3694
- NPI assigned
- Mar 26, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DX6682 | MD | |
| Registered Dietitian | 133V00000X | DI200001674 | DC | Primary |
Addresses
Primary practice location
3001 Park Center Dr Apt 409
Alexandria, VA 22302-1440
Mailing address
3001 Park Center Dr Apt 409
Alexandria, VA 22302-1440
Phone (717) 422-3694
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI200001674 | DC | MD | Registered Dietitian |
| DX6682 | MD | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742947200000",
"number": "1104628528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 PARK CENTER DR APT 409",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223021440",
"telephone_number": "717-422-3694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 PARK CENTER DR APT 409",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223021440",
"telephone_number": "717-422-3694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PICCOLO",
"first_name": "SHANNON",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-26",
"last_updated": "2025-03-26",
"certification_date": "2025-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MD",
"license": "DX6682",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "DC",
"license": "DI200001674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.