NPIMap

Organization Active NPI

Professional Dietitian Services, LLC

  • Health Service Clinic/Center
  • Saint Clair Shores, MI
National Provider Identifier
1114465044
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
F0803N Issued in MI
Legal business name
PROFESSIONAL DIETITIAN SERVICES, LLC
Practice address
29519 Harper Ave
Saint Clair Shores, MI 48081-1275
Phone
(586) 234-3871
Fax
(586) 343-8773
NPI assigned
Feb 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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

Authorized official

Name
Mrs. Amanda Alame, MS, RDN
Title
Registered Dietitian
Phone
(313) 912-4798

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X F0803N MI Primary

Addresses

Primary practice location

29519 Harper Ave
Saint Clair Shores, MI 48081-1275

Mailing address

29519 Harper Ave
Saint Clair Shores, MI 48081-1275
Phone (586) 234-3871

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1486857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490054400000",
    "number": "1114465044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29519 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811275",
            "telephone_number": "586-234-3871",
            "fax_number": "586-343-8773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29519 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811275",
            "telephone_number": "586-234-3871",
            "fax_number": "586-343-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DIETITIAN SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-12",
        "last_updated": "2017-03-21",
        "status": "A",
        "authorized_official_last_name": "ALAME",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "313-912-4798",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, RDN"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "MI",
            "license": "F0803N",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; 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.