Individual ProviderKelly MagoffinDietitian, RegisteredDietary & Nutritional Service ProvidersPractice Address110 Irving St NW Ste 301, Washington, DC 20010-3017(202) 877-7788(703) 629-7495PECOS EnrollmentBased on the most recent information from CMS, provider Kelly Magoffin does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1518501303Provider TypeIndividualFull NameMagoffin, KellyCredentialMS, RD, LDGenderFemaleSole ProprietorYesEnumeration Date11/5/2019Last Updated11/5/2019Contact InformationPractice LocationPractice Address110 Irving St NW Ste 301, Washington, DC 20010-3017Phone(202) 877-7788FaxUnlisted FaxMailing LocationMailing Address18360 Mid Ocean Pl, Leesburg, VA 20176-7451Phone(703) 629-7495FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode133V00000XPrimaryDescriptionDietitian, RegisteredDietary & Nutritional Service ProvidersLicenseDI100000904District of Columbia