NPIMap

Organization Active NPI

Lifelong Good Health

  • Health Service Clinic/Center
  • Woodbridge, VA
National Provider Identifier
1659788909
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
D1100000386 Issued in DC
Legal business name
LIFELONG GOOD HEALTH
Practice address
5721 Rhode Island Dr
Woodbridge, VA 22193
Phone
(703) 389-6612
NPI assigned
Jul 18, 2014
Last updated
Jul 18, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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

Authorized official

Name
Mrs. Lucia Isac Mitchell, RDNPI 1902108137
Title
Registered Dietitian
Phone
(703) 389-6612

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X D1100000386 DC Primary

Addresses

Primary practice location

5721 Rhode Island Dr
Woodbridge, VA 22193

Mailing address

5721 Rhode Island Dr
Woodbridge, VA 22193
Phone (703) 389-6612

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405641600000",
    "number": "1659788909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5721 RHODE ISLAND DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22193",
            "telephone_number": "703-389-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5721 RHODE ISLAND DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22193",
            "telephone_number": "703-389-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELONG GOOD HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-18",
        "last_updated": "2014-07-18",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "LUCIA",
        "authorized_official_middle_name": "ISAC",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "703-389-6612",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "DC",
            "license": "D1100000386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; 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.