Active NPI
Amy L Pang, R.D.
- Registered Dietitian
- Scottsdale, AZ
National Provider Identifier
1033421508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 980380
- Practice address
- 8880 E Desert Cove Ave
Scottsdale, AZ 85260-6746 - Phone
- (480) 314-6670
- Fax
- (480) 257-1997
- NPI assigned
- Jul 12, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 980380 | AZ | Primary |
Addresses
Primary practice location
8880 E Desert Cove Ave
Scottsdale, AZ 85260-6746
Mailing address
PO Box 6423
Chandler, AZ 85246-6423
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 534986 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 980380 | AZ | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429833600000",
"number": "1033421508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6423",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852466423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8880 E DESERT COVE AVE",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852606746",
"telephone_number": "480-314-6670",
"fax_number": "480-257-1997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANG",
"first_name": "AMY",
"middle_name": "L",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-12",
"last_updated": "2015-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AZ",
"license": "980380",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "534986",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.