Individual provider Active NPI

Amanda Chryslan Scippa, RD, LDN

  • Registered Dietitian
  • Woburn, MA
National Provider Identifier
1164906418
Registry record updated Sep 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86028430 Issued in MA
Practice address
2 Oak Knoll Drive
Woburn, MA 01801
Phone
(781) 572-0043
NPI assigned
Sep 22, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2018

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 86028430 MA Primary

Addresses

Primary practice location

2 Oak Knoll Drive
Woburn, MA 01801

Mailing address

2 Oak Knoll Dr
Woburn, MA 01801-3504
Phone (781) 572-0043

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
86028430MAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1537574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537574400000",
    "number": "1164906418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 OAK KNOLL DR",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018013504",
            "telephone_number": "781-572-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 OAK KNOLL DRIVE",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "01801",
            "telephone_number": "781-572-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCIPPA",
        "first_name": "AMANDA",
        "middle_name": "CHRYSLAN",
        "credential": "RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-22",
        "last_updated": "2018-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "86028430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2018; 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.