Active NPI
Constance L. Fulda, RD
- Registered Dietitian
- Silver Spring, MD
National Provider Identifier
1336409135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DX3663
- Practice address
- 13221 Schubert PL
Silver Spring, MD 20904-6865 - Phone
- (301) 246-6255
- Fax
- (301) 936-1994
- NPI assigned
- May 25, 2012
- 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 | DX3663 | MD | Primary |
Addresses
Primary practice location
13221 Schubert PL
Silver Spring, MD 20904-6865
Mailing address
15210 Dino Dr Unit 825
Burtonsville, MD 20866-7536
Phone (301) 246-6255
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2344 | LA | MD | Clinical Social Worker |
| DX3663 | MD | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourishing Lu, LLC | Dietitian, Registered | Current | Accepting new patients |
Locations
15210 Dino Dr
Unit 825
Burtonsville, MD 20866
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": "1337904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659484800000",
"number": "1336409135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15210 DINO DR UNIT 825",
"city": "BURTONSVILLE",
"state": "MD",
"postal_code": "208667536",
"telephone_number": "301-246-6255",
"fax_number": "301-936-1994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13221 SCHUBERT PL",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209046865",
"telephone_number": "301-246-6255",
"fax_number": "301-936-1994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULDA",
"first_name": "CONSTANCE",
"middle_name": "L.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-25",
"last_updated": "2022-08-03",
"certification_date": "2022-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MD",
"license": "DX3663",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.