NPIMap

Organization Active NPI

Viva Velocity, LLC

Doing business as Pearl Nutrition

  • Registered Dietitian
  • Reston, VA
National Provider Identifier
1932743192
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
VIVA VELOCITY, LLC
Doing business as
Pearl Nutrition
Practice address
12330 Pinecrest Rd Ste 125
Reston, VA 20191-1655
Phone
(312) 952-6012
Fax
(844) 246-8462
NPI assigned
Oct 31, 2019
Last updated
Jul 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Authorized official

Name
Carmen J Kresha, RDNPI 1467705079
Title
Owner
Phone
(312) 952-6012

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary
Metabolic Nutrition Registered Dietitian 133VN1006X

Addresses

Primary practice location

12330 Pinecrest Rd Ste 125
Reston, VA 20191-1655

Mailing address

12704 Fantasia Dr
Herndon, VA 20170-2941
Phone (312) 952-6012

Other identifiers 1

IdentifierTypeStateIssuer
1467705079OtherVANPI

Other names 1

  • Pearl Nutrition Doing business as

National Provider Directory

National Provider Directory

Locations

12330 Pinecrest Rd
Reston, VA 20191
Phone (312) 952-6012

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1572480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1932743192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12704 FANTASIA DR",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201702941",
            "telephone_number": "312-952-6012",
            "fax_number": "844-246-8462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12330 PINECREST RD STE 125",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911655",
            "telephone_number": "312-952-6012",
            "fax_number": "844-246-8462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVA VELOCITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-31",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "KRESHA",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-952-6012",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1467705079",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearl Nutrition",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; 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.