Bodacious Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

BODACIOUS NUTRITION LLC

Practice address

2134 S Nelson St
Arlington, VA 22204-5410

Phone

(804) 787-4431

NPI assigned

Dec 11, 2023

Organization subpart

No

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

Authorized official

Name

Joanna R Pustilnik, MS RDN CDCESNPI 1053842518

Title

Owner

Phone

(804) 787-4431

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Bodacious Nutrition LLC Doing business as
• Joanna Pustilnik Doing business as

Practitioners 1

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

• Joanna Pustilnik, MS RDN LDN CDCES

  • Registered Dietitian
  • Arlington, VA
  • NPI 1053842518

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702252800000",
    "number": "1124895024",
    "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": {
        "organization_name": "BODACIOUS NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A",
        "authorized_official_last_name": "PUSTILNIK",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-787-4431",
        "authorized_official_credential": "MS RDN CDCES"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053842518",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bodacious Nutrition LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Joanna Pustilnik",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wendy Bowers Bloom, M.D.
• Blossom ABA Therapy VA
• Ophelia T Boadi
• Ama B Boateng, PMHNP
• Jennifer Cecil Bobbio, D.D.S.
• Mitchel Darvin Bodden II, PHARMD
• Body Connect Physical Therapy
• Karl Samuel Boehm
• Rebecca Bogdanovich-Valdes
• Barbara Bohacova, PHARMD

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.