Amanda Kaylene Humphreys, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2979 Issued in OK

Practice address

52984 423Rd Ave
Talihina, OK 74571-2053

Phone

(580) 272-7689

NPI assigned

Jun 21, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• TX HMO

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Keith & Associates, Inc

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Tulsa, OK
  • NPI 1609061332
  Medicare reassignment NPD
• Renew U Nutrition LLC

  • Registered Dietitian
  • Talihina, OK
  • NPI 1053282277

  Dietitian, Registered

  NPD Authorized official
• Keith & Associates Inc.

  • Durable Medical Equipment & Medical Supplies
  • Tulsa, OK
  • NPI 1487623880
  NPD
• Quality First Medical Supplies LLC

  • Community/Retail Pharmacy
  • Tulsa, OK
  • NPI 1497081988
  NPD (past)
• Quality First Medical Supplies LLC

  • Long Term Care Pharmacy
  • Tulsa, OK
  • NPI 1538301197
  NPD (past)
• Marjorie Nolan Cohn LLC

  • Registered Dietitian
  • New York, NY
  • NPI 1760825160

  Dietitian, Registered

  NPD (past)
• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1718928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1013751395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52984 423RD AVE",
            "city": "TALIHINA",
            "state": "OK",
            "postal_code": "745712053",
            "telephone_number": "580-272-7689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52984 423RD AVE",
            "city": "TALIHINA",
            "state": "OK",
            "postal_code": "745712053",
            "telephone_number": "580-272-7689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 W 3rd St Ste 800",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741033411",
            "country_code": "US",
            "telephone_number": "918-585-3045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUMPHREYS",
        "first_name": "AMANDA",
        "middle_name": "KAYLENE",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-21",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "2979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spencer Holmes
• James Thomas Howard, M.D.
• Barbara Joyce Howell, MD
• Hannah Rae Huddleston
• Rhonda Ruth Huie, PA-C
• Dorothea Shauna Humphreys, MS, LPC
• Jeff Darren Hunter I
• Rebecca Lynn Hunter
• Kelley M James
• Deborah Ann Jarrett, CNM

• Registered Dietitian in Talihina, OK
• Providers in Talihina, OK by specialty
• Registered Dietitian in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.