Active NPI
Laurie Thenedy
- Registered Dietitian
- Reston, VA
National Provider Identifier
1285148197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 11800 Sunrise Valley Dr Ste 700
Reston, VA 20191-5315 - Phone
- (703) 834-1473
- Fax
- (703) 318-7463
- NPI assigned
- Nov 30, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
11800 Sunrise Valley Dr Ste 700
Reston, VA 20191-5315
Mailing address
11800 Sunrise Valley Dr Ste 700
Reston, VA 20191-5315
Phone (703) 834-1473
Other names 1
- Laurie Van Dyk
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221219001144 | VA | Practitioner - Registered Dietitian Or Nutrition Professional | 2466712658 | Practice locations: Virginia Beach, VA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512000000000",
"number": "1285148197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11800 SUNRISE VALLEY DR STE 700",
"city": "RESTON",
"state": "VA",
"postal_code": "201915315",
"telephone_number": "703-834-1473",
"fax_number": "703-318-7463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11800 SUNRISE VALLEY DR STE 700",
"city": "RESTON",
"state": "VA",
"postal_code": "201915315",
"telephone_number": "703-834-1473",
"fax_number": "703-318-7463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THENEDY",
"first_name": "LAURIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-30",
"last_updated": "2017-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LAURIE",
"last_name": "VAN DYK",
"code": "1",
"type": "Former Name"
}
]
}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 Nov 30, 2017; 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.