Liesel Amanda Joy Maddox, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86151077 Issued in TX

Practice address

1942 Broadway Ste 314C
Boulder, CO 80302-5233

Phone

(719) 445-9573

NPI assigned

Jul 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Maddox Nutrition LLC

  • Registered Dietitian
  • Boulder, CO
  • NPI 1053179721

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1225646839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1942 BROADWAY STE 314C",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025233",
            "telephone_number": "197-445-9573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1942 BROADWAY STE 314C",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025233",
            "telephone_number": "719-445-9573"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5830 Granite Pkwy # 100-344",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750246771",
            "country_code": "US",
            "telephone_number": "469-991-9865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "LIESEL",
        "middle_name": "AMANDA JOY",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-20",
        "last_updated": "2024-03-07",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "86151077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary A Macsalka, M.D.
• Sharla Macy, LMFT
• Michelle Maczka
• Jadyn Rose Madden, LPC ASSOCIATE
• Maddox Nutrition LLC
• Maria Madjar, CCC-SLP
• Satori Madrone
• Alexandria Kathleen Maffitt, LCSW
• Morgan Lynne Magill, BCBA
• Elsa Magnusson, RBT

• Registered Dietitian in Boulder, CO
• Providers in Boulder, CO by specialty
• Registered Dietitian in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.