Active NPI
Kelsie Noelle Hitesman, RD, LD, CNSC
- Registered Dietitian
- Falls Church, VA
National Provider Identifier
1568051407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86050957
- Practice address
- 311 Park Ave Ste 1a
Falls Church, VA 22046-3300 - Phone
- (443) 655-5133
- NPI assigned
- Jan 14, 2021
- Last updated
- Jan 14, 2021
- 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 | 86050957 | DC | Primary |
Addresses
Primary practice location
311 Park Ave Ste 1a
Falls Church, VA 22046-3300
Mailing address
6912 Chestnut Ave
Falls Church, VA 22042-1907
Phone (443) 655-5133
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 |
|---|---|---|---|
| 86050957 | DC | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610582400000",
"number": "1568051407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6912 CHESTNUT AVE",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220421907",
"telephone_number": "443-655-5133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 PARK AVE STE 1A",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220463300",
"telephone_number": "443-655-5133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HITESMAN",
"first_name": "KELSIE",
"middle_name": "NOELLE",
"credential": "RD, LD, CNSC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-14",
"last_updated": "2021-01-14",
"certification_date": "2021-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "DC",
"license": "86050957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Falls Church, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.