Dietetic Consultants of Northern Virginia, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2004009119 Issued in MO

Legal business name

DIETETIC CONSULTANTS OF NORTHERN VIRGINIA, LLC

Practice address

2121 Eisenhower Ave
Suite 200
Alexandria, VA 22314-4698

Phone

(703) 519-0901

Fax

(703) 519-0902

NPI assigned

Nov 7, 2007

Last updated

Sep 18, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bonita Lillie, RD, LDNPI 1134305857

Title

President

Phone

(703) 879-5160

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Bonita Lillie, RD

  • Registered Dietitian
  • Alexandria, VA
  • NPI 1134305857

  Dietitian, Registered

  NPD (past) Authorized official

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1831379882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5412 CASTLE BAR LN",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223155519",
            "telephone_number": "703-879-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 EISENHOWER AVE",
            "address_2": "SUITE 200",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223144698",
            "telephone_number": "703-519-0901",
            "fax_number": "703-519-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIETETIC CONSULTANTS OF NORTHERN VIRGINIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-07",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "LILLIE",
        "authorized_official_first_name": "BONITA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-879-5160",
        "authorized_official_credential": "RD, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2004009119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G02785",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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 18, 2008; 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.