Active NPI
Amanda Michelle Connors, MS, RD, CDN, CNSC
- Registered Dietitian
- Summerville, SC
National Provider Identifier
1245701796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86108396
- Practice address
- 505 Bright Leaf Loop
Summerville, SC 29486-8274 - Phone
- (845) 661-8993
- NPI assigned
- Dec 10, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 86108396 | CA | Primary |
Addresses
Primary practice location
505 Bright Leaf Loop
Summerville, SC 29486-8274
Mailing address
505 Bright Leaf Loop
Summerville, SC 29486-8274
Phone (845) 661-8993
Other names 1
- Ms. Amanda Michelle Smith
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 |
|---|---|---|---|
| 86108396 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731456000000",
"number": "1245701796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 BRIGHT LEAF LOOP",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294868274",
"telephone_number": "845-661-8993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 BRIGHT LEAF LOOP",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294868274",
"telephone_number": "845-661-8993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNORS",
"first_name": "AMANDA",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "MS, RD, CDN, CNSC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-12-10",
"last_updated": "2024-11-13",
"certification_date": "2024-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86108396",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "SMITH",
"middle_name": "MICHELLE",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Summerville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.