Active NPI
Jacquelyn Bedwell, RD
- Registered Dietitian
- Washington, DC
National Provider Identifier
1548206147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DX2605
- 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
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 | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 931718 | Other | CDR | |
| DX2605 | Other | MD | LDN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| DX2605 | MD | MD | Registered 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.