Individual provider Active NPI

Amanda Joyce Longolucco, RD

  • Registered Dietitian
  • Norwich, CT
National Provider Identifier
1235965898
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LDN00935 Issued in RI
Practice address
66 Franklin St
Norwich, CT 06360-5806
Phone
(860) 934-4926
Fax
(866) 823-8168
NPI assigned
Sep 10, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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 LDN00935 RI Primary

Addresses

Primary practice location

66 Franklin St
Norwich, CT 06360-5806

Mailing address

9 Ricky LN
Preston, CT 06365-8620
Phone (860) 215-5574

Other names 1

  • Ms. Amanda Joyce McGinn Former name

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
LDN00935RIMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1235965898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 RICKY LN",
            "city": "PRESTON",
            "state": "CT",
            "postal_code": "063658620",
            "telephone_number": "860-215-5574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 FRANKLIN ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063605806",
            "telephone_number": "860-934-4926",
            "fax_number": "866-823-8168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGOLUCCO",
        "first_name": "AMANDA",
        "middle_name": "JOYCE",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "RI",
            "license": "LDN00935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "MCGINN",
            "middle_name": "JOYCE",
            "prefix": "MS.",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.