Individual provider Active NPI

Jacquelyn Bedwell, RD

  • Registered Dietitian
  • Washington, DC
National Provider Identifier
1548206147
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DX2605 Issued in MD
Practice address
Mg886A.4 DTHC Corridor # 8
5801 Army Pentagon
Washington, DC 20310-5801
Phone
(703) 692-8891
NPI assigned
Jun 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 DX2605 MD Primary

Addresses

Primary practice location

Mg886A.4 DTHC Corridor # 8
5801 Army Pentagon
Washington, DC 20310-5801

Mailing address

3501 Chesterbrook CT
Apt 618
Richmond, VA 23233-1296
Phone (804) 387-3200

Other identifiers 2

IdentifierTypeStateIssuer
931718OtherCDR
DX2605OtherMDLDN

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
DX2605MDMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548206147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 CHESTERBROOK CT",
            "address_2": "APT 618",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232331296",
            "telephone_number": "804-387-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MG886A.4 DTHC CORRIDOR # 8",
            "address_2": "5801 ARMY PENTAGON",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "203105801",
            "telephone_number": "703-692-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDWELL",
        "first_name": "JACQUELYN",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "DX2605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDR",
            "identifier": "931718",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LDN",
            "identifier": "DX2605",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.