Individual provider Active NPI

Nicole Stanowski, RD, CDE

  • Diabetes Educator Registered Nurse
  • Ashburn, VA
National Provider Identifier
1295298560
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
959933 Issued in VA
Practice address
21785 Filigree CT Ste 100
Ashburn, VA 20147-6214
Phone
(703) 554-1122
Fax
(703) 554-1047
NPI assigned
Apr 12, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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
Diabetes Educator Registered Nurse 163WD0400X 959933 VA Primary

Addresses

Primary practice location

21785 Filigree CT Ste 100
Ashburn, VA 20147-6214

Mailing address

PO Box 37174
Baltimore, MD 21297-3174
Phone (571) 423-5699

Other practice location 1

510 Butler Ave
Martinsburg, WV 25405-9990
Phone (304) 263-0811 ext. 4516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240524003072 VA Practitioner - Registered Dietitian Or Nutrition Professional 2163864802 Reassigns benefits to 1 organization
I20240530002964 DC Practitioner - Registered Dietitian Or Nutrition Professional 2163864802 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
959933VAMDDiabetes Educator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Nov 28, 2023 Accepting new patients
Inova Health Care Services CurrentSince Apr 23, 2024 Accepting new patients
Inova Health Care Services CurrentSince Nov 28, 2023 Accepting new patients

Locations

21785 Filigree Ct
Ste 100
Ashburn, VA 20147
Phone (703) 554-1100

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

12480 Dillingham Sq
Woodbridge, VA 22192
Phone (703) 491-7177

Organizations & group practices 3

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": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1295298560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37174",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973174",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21785 FILIGREE CT STE 100",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201476214",
            "telephone_number": "703-554-1122",
            "fax_number": "703-554-1047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 Butler Ave",
            "address_purpose": "LOCATION",
            "city": "Martinsburg",
            "state": "WV",
            "postal_code": "254059990",
            "country_code": "US",
            "telephone_number": "304-263-0811 x4516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANOWSKI",
        "first_name": "NICOLE",
        "credential": "RD, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-12",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "VA",
            "license": "959933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.