Ethan O'Connell, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

12304 Willow Woods Dr
Fredericksburg, VA 22407-6659

Phone

(540) 718-8961

NPI assigned

Oct 28, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1710641469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12304 WILLOW WOODS DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224076659",
            "telephone_number": "540-718-8961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12304 WILLOW WOODS DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224076659",
            "telephone_number": "540-718-8961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "ETHAN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-28",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yannick O Nana
• Julie E O'Brien, M.D.
• Megan O'Brien, OTR
• Patricia O'Brien, RN
• Rebecca A O'Bryan, OTR
• Rosemary Cecile O'Grady, D.P.M.
• Dorothy O'Neal
• Barbara Lynne O'Neill, NURSE PRACTITIONER
• Heather Rene O'Quinn, D.C.
• Emerald Dawn O'Sullivan-Mejia, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.

Verify at the official NPI Registry.