Mara Davis, MS, RD, CD-N, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

919705 Issued in VA

Practice address

5901 Kingstowne Village Pkwy Ste 300
Alexandria, VA 22315-5883

Phone

(860) 796-1930

NPI assigned

Apr 25, 2011

Sex

Female

Sole proprietor

No

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

Enrolled in CT, DC2 enrollments

Enrollment records 2

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• MD Nutrition and Lifestyle, LLC

  • Registered Dietitian
  • Kingstowne, VA
  • NPI 1972002301

  DC

  Medicare reassignment Authorized official
• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1770696643
  Medicare reassignment NPD
• Hartford Hospital

  • Surgery Physician
  • Hartford, CT
  • NPI 1407806391
  NPD
• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1902834880
  NPD

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

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1790076883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 BRETTON RD",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574111",
            "telephone_number": "860-796-1930",
            "fax_number": "860-545-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 KINGSTOWNE VILLAGE PKWY STE 300",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223155883",
            "telephone_number": "860-796-1930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "95 Bretton Rd",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "CT",
            "postal_code": "064574111",
            "country_code": "US",
            "telephone_number": "860-796-1930",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 Seymour St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061028000",
            "country_code": "US",
            "telephone_number": "860-972-2604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MARA",
        "name_prefix": "Miss",
        "credential": "MS, RD, CD-N, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-25",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "001415",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "919705",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "VA",
            "license": "919705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claire Catherine Davis, M.S., CCC-SLP
• Crystal Davis, LCSW
• Donald I. Davis, M.D.
• Gregory James Davis, PHARMD
• Lya Davis, MS SLP
• Maya Davis
• Rylea Davis
• Susan Davis, LCSW
• Tanya Renee Davis, MD
• Rebecca Emily Davison

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.