Active NPI
Amy Ellithorpe-Bruant, RDN
- Registered Dietitian
- Los Angeles, CA
National Provider Identifier
1184334252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 619 S Olive St
Los Angeles, CA 90014-1546 - Phone
- (323) 391-7262
- NPI assigned
- Nov 30, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
619 S Olive St
Los Angeles, CA 90014-1546
Mailing address
619 S Olive St
Los Angeles, CA 90014-1546
Phone (323) 391-7262
Other practice location 1
10200 Sepulveda Blvd
Mission Hills, CA 91345-2649
Phone (323) 391-7262
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bamboo Nutrition Therapy, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 3
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.
-
- Registered Dietitian
- Whittier, CA
- NPI 1164917282
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669766400000",
"number": "1184334252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "619 S OLIVE ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900141546",
"telephone_number": "323-391-7262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 S OLIVE ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900141546",
"telephone_number": "323-391-7262"
}
],
"practiceLocations": [
{
"address_1": "10200 Sepulveda Blvd",
"address_purpose": "LOCATION",
"city": "Mission Hills",
"state": "CA",
"postal_code": "913452649",
"country_code": "US",
"telephone_number": "323-391-7262",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ELLITHORPE-BRUANT",
"first_name": "AMY",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-30",
"last_updated": "2022-11-30",
"certification_date": "2022-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.