Active NPI
Robin Amylon, RD
- Sports Dietetics Nutrition Registered Dietitian
- Cambridge, MA
National Provider Identifier
1144853979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Dietetics Nutrition Registered Dietitian
- License
- 4621
- Practice address
- 215 1St St
Cambridge, MA 02142-1213 - Phone
- (617) 491-8989
- NPI assigned
- Feb 20, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | |||
| Sports Dietetics Nutrition Registered Dietitian | 133VN1501X | 4621 | MA | Primary |
Addresses
Primary practice location
215 1St St
Cambridge, MA 02142-1213
Mailing address
215 1St St
Cambridge, MA 02142-1213
Phone (617) 491-8989
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4621 | MA | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cambridge Racquetball Inc | 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": "1582156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582156800000",
"number": "1144853979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 1ST ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021421213",
"telephone_number": "617-491-8989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 1ST ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021421213",
"telephone_number": "617-491-8989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMYLON",
"first_name": "ROBIN",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-20",
"last_updated": "2020-02-20",
"certification_date": "2020-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": false
},
{
"code": "133VN1501X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
"state": "MA",
"license": "4621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.