Active NPI
Amy Joyce Nicholos, MS, RDN ,LD
- Registered Dietitian
- Duluth, GA
National Provider Identifier
1043727993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86077822
- Practice address
- 3980 Gallant Fox CT
Duluth, GA 30096-5416 - Phone
- (678) 386-4809
- NPI assigned
- Jan 1, 2018
- 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 | 86077822 | GA | Primary |
Addresses
Primary practice location
3980 Gallant Fox CT
Duluth, GA 30096-5416
Mailing address
3980 Gallant Fox CT
Duluth, GA 30096-5416
Phone (678) 386-4809
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86077822 | GA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Food for Life, LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514764800000",
"number": "1043727993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3980 GALLANT FOX CT",
"city": "DULUTH",
"state": "GA",
"postal_code": "300965416",
"telephone_number": "678-386-4809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3980 GALLANT FOX CT",
"city": "DULUTH",
"state": "GA",
"postal_code": "300965416",
"telephone_number": "678-386-4809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLOS",
"first_name": "AMY",
"middle_name": "JOYCE",
"credential": "MS, RDN ,LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-01",
"last_updated": "2018-01-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "86077822",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duluth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.