Stephanie Lynn Smith, RDN, IBCLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1031447

Practice address

4375 Fair Lakes CT
Fairfax, VA 22033-4234

Phone

(571) 432-2669

NPI assigned

Feb 11, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1144786583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 FAIR LAKES CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220334234",
            "telephone_number": "571-432-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 FAIR LAKES CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220334234",
            "telephone_number": "571-432-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "RDN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-11",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "1031447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oanh D Smith, RN, NP
• Peter W. Smith, D.D.S.
• Philip Smith, M.D.
• Rhonda Smith, M.A., RESIDENT
• Stephanie Smith, MD
• Tamiko Smith, COTA/L
• Wes Smith, LCSW
• Willow Rose Smith, MA, NCC
• Ximena De Gracia Smith
• Katharine Smorodin

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.