Individual provider Active NPI

Eileen Mary Zdun, M.A.,R.D.,L.D.N.

  • Registered Dietitian
  • MC Lean, VA
National Provider Identifier
1992953574
Registry record updated Sep 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
725898 Issued in VA
Practice address
1360 Beverly Rd
MC Lean, VA 22101-3643
Phone
(703) 552-2722
Fax
(703) 893-0770
NPI assigned
Sep 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 725898 VA Primary
Registered Dietitian 133V00000X DL100000313 DC
Registered Dietitian 133V00000X DX2712 MD

Addresses

Primary practice location

1360 Beverly Rd
MC Lean, VA 22101-3643

Mailing address

1763 Proffit Rd
Vienna, VA 22182-2017
Phone (703) 344-4429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
DL100000313DCMDRegistered Dietitian
DX2712MDMDRegistered Dietitian
725898VAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220832000000",
    "number": "1992953574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1763 PROFFIT RD",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822017",
            "telephone_number": "703-344-4429",
            "fax_number": "703-255-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 BEVERLY RD",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013643",
            "telephone_number": "703-552-2722",
            "fax_number": "703-893-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZDUN",
        "first_name": "EILEEN",
        "middle_name": "MARY",
        "credential": "M.A.,R.D.,L.D.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-08",
        "last_updated": "2008-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "VA",
            "license": "725898",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "DC",
            "license": "DL100000313",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "DX2712",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Lean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.