Individual provider Active NPI

Emily Frizell, RDN

  • Obesity and Weight Management Nutrition Registered Dietitian
  • Fairfax, VA
National Provider Identifier
1962084251
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X
License
1050634 Issued in VA
Practice address
3903 Fair Ridge Dr Ste 209
Fairfax, VA 22033-2944
Phone
(703) 865-6409
NPI assigned
Apr 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X 1050634 VA Primary

Addresses

Primary practice location

3903 Fair Ridge Dr Ste 209
Fairfax, VA 22033-2944

Mailing address

3903 Fair Ridge Dr Ste 209
Fairfax, VA 22033-2944
Phone (703) 865-6409

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Fairfax Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220425000644 SC Practitioner - Registered Dietitian Or Nutrition Professional 9335549070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Path of Life NutritionGroup PAC ID 4082960703, 3 clinicians

Practice addresses (Care Compare)

147 Vera Rd
Suite a
Lexington, SC 29072-3756
Phone (803) 575-0468

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Path of Life Nutrition Nutrition, Obesity and Weight Management CurrentSince Apr 13, 2022 Accepting new patients
Path of Life Nutrition Nutrition, Obesity and Weight Management PastSince Apr 13, 2022 Accepting new patients

Locations

147 Vera Rd
Ste A
Lexington, SC 29072
Phone (803) 575-0468

905 Pope St
Newberry, SC 29108
Phone (803) 575-0468

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": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1962084251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 FAIR RIDGE DR STE 209",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332944",
            "telephone_number": "703-865-6409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 FAIR RIDGE DR STE 209",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332944",
            "telephone_number": "703-865-6409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIZELL",
        "first_name": "EMILY",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-26",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "VA",
            "license": "1050634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Fairfax",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3903 Fair Ridge Dr Ste 209",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220332944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.