Individual provider Active NPI

Denise Victoria Lundy, MS, RD, LD

  • Registered Dietitian
  • Baltimore, MD
National Provider Identifier
1619204138
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DX5200 Issued in MD
Practice address
1111 N Charles St
Baltimore, MD 21201-5505
Phone
(410) 537-6164
NPI assigned
Nov 4, 2009
Last updated
Jan 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 918376 VA
Registered Dietitian 133V00000X DX5200 MD Primary

Addresses

Primary practice location

1111 N Charles St
Baltimore, MD 21201-5505

Mailing address

1400 W Lombard St # 562
Baltimore, MD 21223-3134
Phone (202) 505-3409

Other practice location 1

664 Lincoln St
Portsmouth, VA 23704-4818
Phone (757) 393-6363

Other identifiers 1

IdentifierTypeStateIssuer
202I715417OtherGAMEDICARE PTAN

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
918376VAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Nutrition and Health LLC Dietitian, Registered CurrentSince Apr 30, 2021 Accepting new patients
TLT Consulting Dietitian, Registered PastSince Nov 28, 2018 Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients
Morehouse Healthcare, Inc. PastSince Jul 1, 2012 Accepting new patients

Locations

2727 Enterprise Pkwy
Ste 100
Richmond, VA 23294
Phone (804) 536-9998

Organizations & group practices 4

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": "1257292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1619204138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 W LOMBARD ST # 562",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212233134",
            "telephone_number": "202-505-3409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015505",
            "telephone_number": "410-537-6164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "664 Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237044818",
            "country_code": "US",
            "telephone_number": "757-393-6363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUNDY",
        "first_name": "DENISE",
        "middle_name": "VICTORIA",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-04",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "VA",
            "license": "918376",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "DX5200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "202I715417",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; 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.