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AGAPE DIVINE GOODEN RDN
NPI 1265204648
Dietitian, Registered in Fairfax, VA

Active since October 27, 2023
3903 FAIR RIDGE DR STE 209, FAIRFAX, VA 22033(703) 865-6490 Get Directions Write a Review

NPPES record last updated: November 15, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 15, 2023, Oct 27, 2023 (2 updates tracked since 2023).

About Agape Divine Gooden Rdn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AGAPE DIVINE GOODEN RDN (NPI 1265204648) is an individual dietitian, registered in Fairfax, Virginia, licensed in District Of Columbia (DI200001245) and active in the NPI registry since October 2023. She maintains a secondary practice location in Landsowne.

NPPES Registry Identity

NPI1265204648
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameAGAPE DIVINE GOODENCredential: RDN
Location Address3903 FAIR RIDGE DR STE 209Fairfax, VA 22033-2944
Mailing Address4820 31st St S Ste BArlington, VA 22206-1665 · (703) 865-6490
Phone(703) 865-6490
Sole ProprietorNo
Enumeration DateOctober 27, 2023
Last NPPES UpdateNovember 15, 20232 updates tracked since enumeration
NPPES CertifiedNovember 15, 2023
✔ NPI 1265204648 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in DC · DI200001245
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
3903 FAIR RIDGE DR STE 209, Fairfax, VA 22033
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Secondary Practice Location 1

Location 119415 Deerfield Avenue, Suite 202Landsowne, VA 20176 · Phone (703) 865-6490

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Agape Divine Gooden Rdn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Agape Gooden reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Privia Medical Group, LLC
14 mi
Internal Medicine
950 N GLEBE RD STE 700
Arlington, VA 22203
  • Reassigned Medicare billing, District of Columbia and Virginia enrollments
  • 1,534 clinicians in this Medicare group
NPI 1013042480 (571) 366-8850

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GRACE ANN FOLTZ MS, RDN
Dietitian, Registered
3903 FAIR RIDGE DR STE 209
FAIRFAX, VA 22033
Fairfax County (703) 865-6490
HEIDI RUTH HUNNICUTT
Dietitian, Registered
3903 FAIR RIDGE DR STE 209
FAIRFAX, VA 22033
Fairfax County (703) 865-6490
ASHLEY HANNAH DEGEARE NDTR
Dietetic Technician, Registered
3903 FAIR RIDGE DR STE 209
FAIRFAX, VA 22033
Fairfax County (703) 865-6490
BRIANNA DARLING CNS
Nutritionist
3903 FAIR RIDGE DR STE 209
FAIRFAX, VA 22033
Fairfax County (703) 865-6490
MRS. KELLY KATHRYN MCGUFFIN RD
Dietitian, Registered
3903 FAIR RIDGE DR STE 209
FAIRFAX, VA 22033
Fairfax County (703) 424-9676
DASEULI JEONG
Family Medicine (Obesity Medicine)
3903 FAIR RIDGE DR STE 209
FAIRFAX, VA 22033
Fairfax County (703) 865-6490
SHINDA STARR NURSE PRACTITIONER
Nurse Practitioner (Family)
3903 FAIR RIDGE DR STE 209
FAIRFAX, VA 22033
Fairfax County (703) 424-9676
EDEN ZACHARIAH R.D.N
Dietitian, Registered (Nutrition, Obesity and Weight Management)
3903 FAIR RIDGE DR STE 209
FAIRFAX, VA 22033
Fairfax County (703) 865-6490

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Agape Gooden's NPI number?

The NPI number for Agape Gooden is 1265204648. It was assigned to this individual provider in the NPPES registry on October 27, 2023.

Where is Agape Gooden located?

Agape Gooden practices at 3903 Fair Ridge Dr Ste 209, Fairfax, VA 22033. The listed phone number is (703) 865-6490.

What is Agape Gooden's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Agape Gooden enrolled in Medicare?

Yes. Agape Gooden is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Agape Gooden's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Agape Gooden reassigns Medicare benefits to Privia Medical Group, LLC (Arlington, VA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Agape Gooden's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Agape Gooden was last updated on November 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.