Amanda Huber

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

103 Medicine Way Rd
Peridot, AZ 85542-5000

Phone

(217) 820-8705

NPI assigned

Mar 23, 2023

Last updated

Jul 15, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• San Carlos Apache Healthcare Corporation

  • Critical Access Hospital Clinic/Center
  • Peridot, AZ
  • NPI 1265813075

  TX

  Medicare reassignment NPD
• The Fort Defiance Indian Hospital Board, Incorporation

  dba Fort Defiance Indian Hospital

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1477876639

  TX

  Medicare reassignment NPD
• San Carlos Apache Healthcare Corporation

  dba Clarence Wesley Health Center

  • Clinic/Center
  • Bylas, AZ
  • NPI 1417330713
  NPD

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1033812581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 BIG BEND RD",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625689101",
            "telephone_number": "217-820-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MEDICINE WAY RD",
            "city": "PERIDOT",
            "state": "AZ",
            "postal_code": "855425000",
            "telephone_number": "217-820-8705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Corner of Route N12 and N7",
            "address_purpose": "LOCATION",
            "city": "Fort Defiance",
            "state": "AZ",
            "postal_code": "865040649",
            "country_code": "US",
            "telephone_number": "928-729-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUBER",
        "first_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norman Joseph Garzella, RPH
• Brandon Thomas Goodman, DPT
• Chris Brian Gurtler, RN
• Kendal Hatler, DPT
• Camilee Hayes, NP
• Katie Jorgensen
• Jesse Kusmulyana, PTA
• Susan Lachica, PSYD
• Jason Lau, PHARM.D
• Leanna H Le

• Registered Dietitian in Peridot, AZ
• Providers in Peridot, AZ by specialty
• Registered Dietitian in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; 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.