Individual provider Active NPI

Rebecca A Lake, RD

  • Registered Dietitian
  • Silver Spring, MD
National Provider Identifier
1205590601
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86113932 Issued in MD
Practice address
10770 Columbia Pike Ste 300
Silver Spring, MD 20901-4439
Phone
(240) 452-1211
NPI assigned
Oct 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86113932 MD Primary

Addresses

Primary practice location

10770 Columbia Pike Ste 300
Silver Spring, MD 20901-4439

Mailing address

10770 Columbia Pike Ste 300
Silver Spring, MD 20901-4439
Phone (301) 304-7858

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
86113932MDMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Stellar Health Nutrition, LLC Past Accepting new patients

Organizations & group practices 1

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": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1205590601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10770 COLUMBIA PIKE STE 300",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209014439",
            "telephone_number": "301-304-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10770 COLUMBIA PIKE STE 300",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209014439",
            "telephone_number": "240-452-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "REBECCA",
        "middle_name": "A",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-22",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "86113932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.