Lucia Isac Mitchell, RD
Individual provider Active NPI Registered Dietitian · Dumfries, VA
NPI 1902108137 · NPPES record last updated Sep 22, 2015
Key facts
- NPI
- 1902108137
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 1040898 (DC)
- Practice address
- 700 Fettler Park
Dumfries Health Center
Dumfries, VA 22025 - Phone
- (703) 441-7500
- Fax
- (202) 269-7484
- NPI assigned
- Nov 19, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1040898 | DC | MD | Registered Dietitian |
| D1100000386 | DC | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifelong Good Health | Current | Accepting new patients | |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | D1100000386 | DC | |
| Registered Dietitian | 133V00000X | 1040898 | DC | Yes |
Addresses
Primary practice location
700 Fettler Park
Dumfries Health Center
Dumfries, VA 22025
Mailing address
3700 Fettler Park
Dumfries Health Center
Dumfries, VA 22025
Phone (703) 441-7500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1040898 | Other | DC | REGISTER DIETITIAN (RD) |
| D1100000386 | Other | DC | DIETITIAN LICENSE |
Other providers in Dumfries, VA
- Mental Health CPR, LLC
- Hermon Mesfin
- Elizabeth Mikus
- Mavis Mintaah
- Seyed Ali Mirsaeide-Farahani
- Desiree Andreina Monger Marquez
- Angela Faye Monroe
- Moore Home Care LLC
- Althilia Theresa Moore
- Nikia Moore
All providers in Dumfries, VA · Registered Dietitian in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.