Active NPI
Amanda Evans, MS, RDN, CDE
- Registered Dietitian
- Charlevoix, MI
National Provider Identifier
1215587498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 979467
- Practice address
- 09210 North Pointe Woods Drive
Charlevoix, MI 49720 - Phone
- (231) 237-8100
- NPI assigned
- Sep 18, 2019
- Last updated
- Jul 21, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 979467 | MI | Primary |
Addresses
Primary practice location
09210 North Pointe Woods Drive
Charlevoix, MI 49720
Mailing address
09210 North Pointe Woods Drive
Charlevoix, MI 49720
Phone (231) 237-8100
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 979467 | MI | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Registered Dietitian
- Charlevoix, MI
- NPI 1003449794
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595289600000",
"number": "1215587498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "09210 NORTH POINTE WOODS DRIVE",
"city": "CHARLEVOIX",
"state": "MI",
"postal_code": "49720",
"telephone_number": "231-237-8100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "09210 NORTH POINTE WOODS DRIVE",
"city": "CHARLEVOIX",
"state": "MI",
"postal_code": "49720",
"telephone_number": "231-237-8100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "AMANDA",
"credential": "MS, RDN, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-18",
"last_updated": "2020-07-21",
"certification_date": "2020-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MI",
"license": "979467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlevoix, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.