Individual provider Active NPI

Kelly Kathryn McGuffin, RD

  • Registered Dietitian
  • Fairfax, VA
National Provider Identifier
1295820553
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
859065 Issued in VA
Practice address
3903 Fair Ridge Dr Ste 209
Fairfax, VA 22033-2944
Phone
(703) 424-9676
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2021

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
Registered Dietitian 133V00000X 859065 VA Primary

Addresses

Primary practice location

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

Mailing address

24618 Salmon River PL
Aldie, VA 20105-5534
Phone (540) 908-5538

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050608000882 VA Practitioner - Registered Dietitian Or Nutrition Professional 4183667389 Reassigns benefits to 1 organization
I20131113000913 DC Practitioner - Registered Dietitian Or Nutrition Professional 4183667389 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince May 12, 2021 Accepting new patients
Privia Medical Group, LLC CurrentSince May 12, 2021 Accepting new patients
University of Virginia Physicians Group Past Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

22895 Brambleton Plz
Ste 200
Brambleton, VA 20148
Phone (703) 220-0779

3903 Fair Ridge Dr
Ste 209
Fairfax, VA 22033
Phone (571) 349-2191

8644 Sudley Rd
#220
Manassas, VA 20110

8130 Boone Blvd
Ste 110
Vienna, VA 22182
Phone (703) 362-4260

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kelly.mcguffin.1@8042.direct.athenahealth.com

Organizations & group practices 5

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1295820553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24618 SALMON RIVER PL",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201055534",
            "telephone_number": "540-908-5538"
        },
        {
            "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": "703-424-9676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGUFFIN",
        "first_name": "KELLY",
        "middle_name": "KATHRYN",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "VA",
            "license": "859065",
            "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 May 5, 2021; 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.