Amanda Widmar, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

1432 S Dobson Rd Ste 107
Mesa, AZ 85202-4769

Phone

(480) 681-4453

NPI assigned

Apr 28, 2026

Sex

Female

Sole proprietor

No

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 AZ

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1821368218
  Medicare reassignment

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

{
    "created_epoch": "1777334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1124964424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 S KYRENE RD UNIT 133",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852264490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 S DOBSON RD STE 107",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024769",
            "telephone_number": "480-681-4453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDMAR",
        "first_name": "AMANDA",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-28",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie Lynn Wick, N.D.
• Jonathan Wickes, PHARMD
• Linda C. Wicoff, RDH
• Morgan Widger
• Jennifer Widjaja
• Lawrence Wieland, LISAC
• Kristan Kay Wiemann, RN
• Belinda Wiens, M.C., LPC
• Harry Jake Wiens, MD
• Thomas Bryan Wiggins Jr., CSA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.