Active NPI
Amanda Lynn Berardi, MS, RDN
- Registered Dietitian
- Mount Laurel, NJ
National Provider Identifier
1043812100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86154110
- Practice address
- 20 Wendover Dr
Mount Laurel, NJ 08054-3328 - Phone
- (267) 253-4411
- NPI assigned
- Nov 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 86154110 | PA | Primary |
Addresses
Primary practice location
20 Wendover Dr
Mount Laurel, NJ 08054-3328
Mailing address
20 Wendover Dr
Mount Laurel, NJ 08054-3328
Phone (267) 253-4411
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86154110 | PA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605225600000",
"number": "1043812100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 WENDOVER DR",
"city": "MOUNT LAUREL",
"state": "NJ",
"postal_code": "080543328",
"telephone_number": "267-253-4411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 WENDOVER DR",
"city": "MOUNT LAUREL",
"state": "NJ",
"postal_code": "080543328",
"telephone_number": "267-253-4411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERARDI",
"first_name": "AMANDA",
"middle_name": "LYNN",
"name_prefix": "Miss",
"credential": "MS, RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-13",
"last_updated": "2020-11-13",
"certification_date": "2020-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "86154110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Laurel, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.