Individual provider Active NPI

Amanda Falconer Wolff, MPH, RD

  • Registered Dietitian
  • Gilbert, AZ
National Provider Identifier
1104073360
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
954463 Issued in AZ
Practice address
2745 E Via de Palmas
Gilbert, AZ 85298-2071
Phone
(805) 252-3979
NPI assigned
Aug 19, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 954463 AZ Primary

Addresses

Primary practice location

2745 E Via de Palmas
Gilbert, AZ 85298-2071

Mailing address

2745 E Via de Palmas
Gilbert, AZ 85298-2071
Phone (805) 252-3979

Other names 1

  • Amanda Jean Falconer Former name

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

State licenses

LicenseStateTypeSpecialty
954463AZMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219104000000",
    "number": "1104073360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2745 E VIA DE PALMAS",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852982071",
            "telephone_number": "805-252-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 E VIA DE PALMAS",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852982071",
            "telephone_number": "805-252-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFF",
        "first_name": "AMANDA",
        "middle_name": "FALCONER",
        "credential": "MPH, RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "954463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "FALCONER",
            "middle_name": "JEAN",
            "credential": "REGISTERED DIETITIAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.