Amy Dickerson, Rd, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

AMY DICKERSON, RD, LLC

Practice address

9085 Dahlgren Road
King George, VA 22485-3506

Phone

(804) 874-2575

NPI assigned

Aug 5, 2024

Last updated

Aug 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amy H Dickerson, RDNPI 1578250957

Title

Owner

Phone

(804) 874-2575

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amy Hargrave Dickerson, RDN

  • Registered Dietitian
  • King George, VA
  • NPI 1578250957

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1174353213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9085 DAHLGREN ROAD",
            "city": "KING GEORGE",
            "state": "VA",
            "postal_code": "224853506",
            "telephone_number": "804-874-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9085 DAHLGREN ROAD",
            "city": "KING GEORGE",
            "state": "VA",
            "postal_code": "224853506",
            "telephone_number": "804-874-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY DICKERSON, RD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-04",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-874-2575",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Yeu Jin Baik, DDS
• Christina Alise Beach

• Registered Dietitian in King George, VA
• Providers in King George, VA by specialty
• Registered Dietitian in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.