Individual provider Active NPI

Alexandra Nicole Ponce Arcilla, RDN, LDN

  • Registered Dietitian
  • North Bethesda, MD
National Provider Identifier
1336737865
Registry record updated Jan 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DX3866 Issued in MD
Practice address
11710 Old Georgetown Rd Apt 820
North Bethesda, MD 20852-2696
Phone
(240) 899-7578
NPI assigned
Jan 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DX3866 MD Primary

Addresses

Primary practice location

11710 Old Georgetown Rd Apt 820
North Bethesda, MD 20852-2696

Mailing address

5268 Nicholson LN Ste G-204
Kensington, MD 20895-1009

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

LicenseStateTypeSpecialty
DX3866MDMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610236800000",
    "number": "1336737865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5268 NICHOLSON LN STE G-204",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208951009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11710 OLD GEORGETOWN RD APT 820",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208522696",
            "telephone_number": "240-899-7578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCILLA",
        "first_name": "ALEXANDRA NICOLE",
        "middle_name": "PONCE",
        "credential": "RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-10",
        "last_updated": "2021-01-10",
        "certification_date": "2021-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "DX3866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.