Mary Lynn Farivari, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

D1100000130 Issued in DC

Practice address

2100 Pennsylvania Ave NW
Washington, DC 20037-3202

Phone

(202) 872-7055

Fax

(202) 872-7132

NPI assigned

Jan 31, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mid Atlantic Pemanente Medical Group

  • Health Maintenance Organization
  • Rockville, MD
  • NPI 1811062763
  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1457498958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 EAST JEFFERSON ST",
            "address_2": "KAISER PERMANENTE 3 WEST ATTN: SANJAY MATHUR-DATA MGMT",
            "city": "ROCVILLE",
            "state": "MD",
            "postal_code": "208524908",
            "telephone_number": "301-816-7446",
            "fax_number": "301-816-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 PENNSYLVANIA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200373202",
            "telephone_number": "202-872-7055",
            "fax_number": "202-872-7132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARIVARI",
        "first_name": "MARY",
        "middle_name": "LYNN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "DC",
            "license": "D1100000130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RD ID NUMBER",
            "identifier": "725254",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2100 Pennsylvania Ave NW",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200373202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Annette Corina Faria Pena, MD
• Parham Farid, M.D.
• Michael Farina
• Faris Z Hakki, M.D.
• Barbara Germond Farishian, D.D.S.
• Alyssa Farkas
• Alice Gutknecht Farley, MD
• Cheryl Farley
• Colleen Bridget Farley, RN
• Danielle D Farley, APRN

• Registered Dietitian in Washington, DC
• Providers in Washington, DC by specialty
• Registered Dietitian in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.