Andrea Addley

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

6511772-4901 Issued in UT

Practice address

1174 E Graystone Way Ste 1a
Salt Lake City, UT 84106-2671

Phone

(801) 664-2182

NPI assigned

Jan 26, 2013

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 5, 2025.

{
    "created_epoch": "1359158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1013255066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 RANCH LOOP RD",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "832635116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 E GRAYSTONE WAY STE 1A",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062671",
            "telephone_number": "801-664-2182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDLEY",
        "first_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-26",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "UT",
            "license": "6511772-4901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alexander Rhys Adelman
• Julia Adelman, MD
• Marisa Rachel Adelman, MD
• Harry Adelson, ND

• All providers in Salt Lake City, UT
• Registered Dietitian in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.