Thea N Boatswain, MS, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

13800 Coppermine Rd FL 123
Herndon, VA 20171-6163

Phone

(202) 600-9826

NPI assigned

Jan 9, 2020

Last updated

Dec 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Elan Fitness and Nutrition

  • Registered Dietitian
  • McLean, VA
  • NPI 1104450238

  Nutritionist

  NPD Authorized official

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1679113369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13800 COPPERMINE RD FL 123",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201716163",
            "telephone_number": "202-600-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13800 COPPERMINE RD FL 123",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201716163",
            "telephone_number": "202-600-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOATSWAIN",
        "first_name": "THEA",
        "middle_name": "N",
        "credential": "MS, RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-09",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelly Blanco Gonzalez
• Jennifer Blanding, PA-C
• Shannon Bloch, DC
• Victoria Block, PT
• Bloom Home Care LLC
• Elisabeth Anne Boettke, NP
• Ioana Boie, PHD
• Ariel Bolt, FNP-BC
• Sage Annaleise Bolte, PHD, LCSW, OSW-C
• Aruna Borkar, MSPT

• Registered Dietitian in Herndon, VA
• Providers in Herndon, VA by specialty
• Registered Dietitian in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.