Active NPI
Amanda May Gordon, R.D.
- Registered Dietitian
- Monroe, LA
National Provider Identifier
1245225358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1922
- Practice address
- 309 Jackson St
Monroe, LA 71201-7407 - Phone
- (318) 327-4072
- Fax
- (318) 327-4069
- NPI assigned
- Sep 14, 2005
- 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 | 1922 | LA | Primary |
Addresses
Primary practice location
309 Jackson St
Monroe, LA 71201-7407
Mailing address
126 Crestview Dr
West Monroe, LA 71291-7553
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245225358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 CRESTVIEW DR",
"city": "WEST MONROE",
"state": "LA",
"postal_code": "712917553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 JACKSON ST",
"city": "MONROE",
"state": "LA",
"postal_code": "712017407",
"telephone_number": "318-327-4072",
"fax_number": "318-327-4069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "AMANDA",
"middle_name": "MAY",
"name_prefix": "Mr.",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "LA",
"license": "1922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.