Active NPI
Shaina Duvall, RD
- Registered Dietitian
- Reston, VA
National Provider Identifier
1154025583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND8618
- Practice address
- 11696 Stockbridge LN
Reston, VA 20194-1608 - Phone
- (571) 749-5548
- NPI assigned
- Mar 29, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | ND8618 | FL | Primary |
| Registered Dietitian | 133V00000X | DX5192 | MD |
Addresses
Primary practice location
11696 Stockbridge LN
Reston, VA 20194-1608
Mailing address
11654 Plaza America Dr
Reston, VA 20190-4700
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 |
|---|---|---|---|
| ND8618 | FL | MD | Registered Dietitian |
| DX5192 | MD | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellness by Shaina, LLC | Dietitian, Registered | Current | Accepting new patients |
| Fay Nutrition | 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": "1680048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681430400000",
"number": "1154025583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11654 PLAZA AMERICA DR",
"city": "RESTON",
"state": "VA",
"postal_code": "201904700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11696 STOCKBRIDGE LN",
"city": "RESTON",
"state": "VA",
"postal_code": "201941608",
"telephone_number": "571-749-5548"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUVALL",
"first_name": "SHAINA",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-29",
"last_updated": "2023-04-14",
"certification_date": "2023-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND8618",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MD",
"license": "DX5192",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.