Individual provider Active NPI

Ethan Okunas, RD

  • Registered Dietitian
  • Ijamsville, MD
National Provider Identifier
1821840695
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DX6437 Issued in MD
Practice address
2903 Loch Haven CT
Ijamsville, MD 21754-8813
Phone
(508) 333-8639
NPI assigned
Apr 3, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DX6437 MD Primary

Addresses

Primary practice location

2903 Loch Haven CT
Ijamsville, MD 21754-8813

Mailing address

2903 Loch Haven CT
Ijamsville, MD 21754-8813
Phone (508) 333-8639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240415001177 MD Practitioner - Registered Dietitian Or Nutrition Professional 3779922471 Reassigns benefits to 1 organization
I20240417003163 DC Practitioner - Registered Dietitian Or Nutrition Professional 3779922471 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DX6437MDMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Health Weight Management, LLC Dietitian, Registered CurrentSince Apr 1, 2024 Accepting new patients
Base Performance LLC Dietitian, Registered CurrentSince Jun 8, 2025 Accepting new patients

Locations

6700 Race Track Rd
Bowie, MD 20715
Phone (301) 383-2581

499 Idlewild Ave
Ste 104
Easton, MD 21601
Phone (410) 697-3832

1099 Winterson Rd
Ste 300
Linthicum Heights, MD 21090
Phone (443) 929-1785

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1821840695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2903 LOCH HAVEN CT",
            "city": "IJAMSVILLE",
            "state": "MD",
            "postal_code": "217548813",
            "telephone_number": "508-333-8639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2903 LOCH HAVEN CT",
            "city": "IJAMSVILLE",
            "state": "MD",
            "postal_code": "217548813",
            "telephone_number": "508-333-8639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKUNAS",
        "first_name": "ETHAN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-03",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "DX6437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ijamsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.