NPIMap

Individual provider Active NPI

Jennifer Ansio Headley-Bunns, R.D., L.D.

  • Registered Dietitian
  • Largo, MD
National Provider Identifier
1194980300
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
D185 Issued in DC
Practice address
411 Kettering Dr
Largo, MD 20774-1522
Phone
(301) 336-6980
Fax
(301) 808-7964
NPI assigned
Jul 28, 2008
Last updated
Jul 28, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X D185 DC Primary
Registered Dietitian 133V00000X D00768 MD

Addresses

Primary practice location

411 Kettering Dr
Largo, MD 20774-1522

Mailing address

411 Kettering Dr
Largo, MD 20774-1522
Phone (301) 336-6980

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

LicenseStateTypeSpecialty
D185DCMDRegistered Dietitian
D00768MDMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217203200000",
    "number": "1194980300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 KETTERING DR",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207741522",
            "telephone_number": "301-336-6980",
            "fax_number": "301-808-7964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 KETTERING DR",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207741522",
            "telephone_number": "301-336-6980",
            "fax_number": "301-808-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEADLEY-BUNNS",
        "first_name": "JENNIFER",
        "middle_name": "ANSIO",
        "name_prefix": "Ms.",
        "credential": "R.D., L.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2008-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "DC",
            "license": "D185",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "D00768",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; 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.