Active NPI
Hadiya Crichlow
- Registered Dietitian
- Fairfax, VA
National Provider Identifier
1295512416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86020228
- Practice address
- 11166 Fairfax Blvd Ste 500
Fairfax, VA 22030-5017 - Phone
- (516) 209-4104
- NPI assigned
- Sep 11, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | 86020228 | NY | Primary |
Addresses
Primary practice location
11166 Fairfax Blvd Ste 500
Fairfax, VA 22030-5017
Mailing address
1 Store Hill Rd Unit 75
Old Westbury, NY 11568-3003
Phone (516) 209-4104
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
| License | State | Type | Specialty |
|---|---|---|---|
| 86020228 | NY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | 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": "1694390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707523200000",
"number": "1295512416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 STORE HILL RD UNIT 75",
"city": "OLD WESTBURY",
"state": "NY",
"postal_code": "115683003",
"telephone_number": "516-209-4104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11166 FAIRFAX BLVD STE 500",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220305017",
"telephone_number": "516-209-4104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRICHLOW",
"first_name": "HADIYA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-11",
"last_updated": "2024-02-10",
"certification_date": "2024-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "86020228",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.