TIDEWATER NUTRITION LLC (NPI# 1710585245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710585245 |
| Entity Type | Organization |
| Organization Name | TIDEWATER NUTRITION LLC |
| Practice Address |
120 Mckenney Ln Centreville MD 21617-2139 |
| Mailing Address |
600-b Abruzzi Drive Pmb #120 Chester MD 21619 |
| Practice Telephone | 4102790621 |
| Mailing Telephone | 4102790621 |
| Enumeration Date | 2020-10-16 |
| Last Update Date | 2020-10-16 |
| Authorized Official Name | MOLLY RUSCH (REGISTERED DIETITIAN) |
| Authorized Official Telephone | 4102790621 |
| Authorized Official Credential | RDN, LDN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| Street Address |
120 MCKENNEY LN |
| City | CENTREVILLE |
| State | MD |
| Zip Code | 21617-2139 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710122411 | Molly Lynn Rusch | Dietitian, Registered | 120 Mckenney Ln, Centreville, MD 21617-2139 | 2008-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518322445 | Marianna Edmonston | Occupational Therapy Assistant | 205 Armstrong St., Genesis Rehabilitation Services Corsica Hills, Centreville, MD 21617 | 2015-12-18 |
| 1881089084 | Michelle Katherine Priddy | Specialist/Technologist | 125 Ruthsburg Rd., Centreville, MD 21617 | 2015-04-03 |
| 1801220579 | Kimberly Patrice Wilson | Counselor | 205 North Liberty St, Centreville, MD 21617 | 2013-08-29 |
| 1588940787 | Angela Renee Sommer | Speech-Language Pathologist | 205 Armstrong Street, Genesis Rehabilitation Services Corsica Hills, Centreville, MD 21617 | 2011-11-01 |
| 1497067144 | Alison Lynn Mccuen | Speech-Language Pathologist | 175 Ashland Drive, Centreville, MD 21617 | 2010-07-10 |
| 1427269406 | Hospice of Queen Anne's Inc. | Hospice Care, Community Based | 255 Comet Drive, Centreville, MD 21617 | 2007-05-24 |
| 1093921470 | Lillian Sheehan | Social Worker | 152 Courseval Drive, Ste 142, Centreville, MD 21617 | 2007-05-15 |
| 1184723942 | Centreville Drugs Inc | Durable Medical Equipment & Medical Supplies | 102 Commerce Street, Centreville, MD 21617 | 2006-09-21 |
| 1114022670 | James J Lucas | Dentist | 134 Coursevall Drive, Centerville, MD 21617 | 2006-09-13 |
| 1730129370 | Joseph C Titus | Social Worker | 120 Banjo Lane, Centreville, MD 21617 | 2006-06-08 |
| Find all providers in zip 21617 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902370935 | Leslie Flory | Dietitian, Registered | 13919 Cristo Ct, Centreville, VA 20120-1217 | 2019-01-12 |
| 1710122411 | Molly Lynn Rusch | Dietitian, Registered | 120 Mckenney Ln, Centreville, MD 21617-2139 | 2008-12-09 |
| 1952900763 | Danielle Victoria Williams | Dietitian, Registered | 5900 Bond Ave, Centreville, IL 62207-2326 | 2020-10-22 |
| 1578034609 | Jennifer Wuerffel | Dietitian, Registered | 5900 Bond Ave, Centreville, IL 62207-2326 | 2018-12-16 |
| 1952761025 | Amelia Foster | Dietitian, Registered | 405 Belcher St, Centreville, AL 35042-2946 | 2016-03-02 |
| 1629498266 | Jami Szwargulski | Dietitian, Registered | 5900 Bond Ave, Centreville, IL 62207-2326 | 2014-04-22 |
| 1902113301 | Birgit Sterzl | Dietitian, Registered | 5900 Bond Ave, Centreville, IL 62207-2326 | 2010-09-07 |
| 1508173907 | Michele C Schifferdecker | Dietitian, Registered | 5900 Bond Ave, Centreville, IL 62207-2326 | 2010-09-07 |
| 1114185691 | Jewel Causey | Dietitian, Registered | 270 E Main St, Centreville, MS 39631-4200 | 2008-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922609791 | Emily Chapman | Dietitian, Registered | 8901 Rockville Pike Rm 348, Bethesda, MD 20889-0001 | 2020-11-06 |
| 1629679436 | Anna Carey Smith | Dietitian, Registered | 8901 Rockville Pike Rm 3103, Bethesda, MD 20889-0001 | 2020-11-06 |
| 1124629761 | Chantelle A Raines | Dietitian, Registered | 4560 Crain Hwy Ste 1, White Plains, MD 20695-3084 | 2020-11-02 |
| 1295336881 | Luminita Alina Bota | Dietitian, Registered | 4560 Crain Hwy Ste 101, White Plains, MD 20695-3084 | 2020-11-02 |
| 1174123962 | Rachel Coury | Dietitian, Registered | 539 Allegheny Ave, Towson, MD 21204-4233 | 2020-10-29 |
| 1699373761 | Bailey Elizabeth Saneman | Dietitian, Registered | 2102 Wiley Rd, Jarrettsville, MD 21084-1801 | 2020-10-12 |
| 1770180176 | Nu Flora LLC | Dietitian, Registered | 10904 Gunpowder Dr, Fort Washington, MD 20744-4155 | 2020-10-08 |
| 1407453228 | Caroline Pearson Tussing | Dietitian, Registered | 11237 Greenspring Ave, Lutherville Timonium, MD 21093-3510 | 2020-10-05 |
| 1568069557 | Huong Nguyen | Dietitian, Registered | 2262 Audrey Manor Ct, Waldorf, MD 20603-4918 | 2020-10-03 |
| 1316544562 | Paige Kalyani | Dietitian, Registered | 118 E Oak Ridge Dr Ste 1100, Hagerstown, MD 21740-7793 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
| City | CENTREVILLE |
| Zip Code | 21617 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.