Agape Divine Gooden, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

3903 Fair Ridge Dr Ste 209
Fairfax, VA 22033-2944

Phone

(703) 865-6490

NPI assigned

Oct 27, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: agape.gooden.1@8042.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  DC

  Medicare reassignment NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Medical Associates of Central Virginia, Inc.

  • Internal Medicine Physician
  • Lynchburg, VA
  • NPI 1912970260
  NPD (past)

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

{
    "created_epoch": "1698364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1265204648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4820 31ST ST S STE B",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222061665",
            "telephone_number": "703-865-6490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 FAIR RIDGE DR STE 209",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332944",
            "telephone_number": "703-865-6490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19415 Deerfield Avenue",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "Landsowne",
            "state": "VA",
            "postal_code": "20176",
            "country_code": "US",
            "telephone_number": "703-865-6490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODEN",
        "first_name": "AGAPE",
        "middle_name": "DIVINE",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-27",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "DC",
            "license": "DI200001245",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodolfo Gonzalez, LCSW
• Sheila Melissa Gonzalez
• Good Company Therapy Group LLC
• Good Hope Healthcare Services, LLC
• Allison Renee Goodeman, MOT OTR/L
• Elizabeth Shelly Goodiel, C.R.N.F.A,M.S.N.,CNM
• Kristen Nicole Goodman
• Kristin Bentivogli Goodman, DPT
• Sarah Nicole Goodman, NONE
• Stephen J Goodman, MD

• 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 Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.