Individual provider Active NPI

Amanda Jean Esquibel, MS, RD, LD

  • Registered Dietitian
  • Las Cruces, NM
National Provider Identifier
1245851369
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD-1050 Issued in NM
Practice address
1155 S Telshor Blvd Ste 301
Las Cruces, NM 88011-4757
Phone
(575) 649-0073
NPI assigned
Apr 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DT83980 TX
Registered Dietitian 133V00000X LD-1050 NM Primary

Addresses

Primary practice location

1155 S Telshor Blvd Ste 301
Las Cruces, NM 88011-4757

Mailing address

C/O BBP Services LLC
1180 Commerce Dr Unit 13880
Las Cruces, NM 88013-4636
Phone (575) 649-0073

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LD-1050NMMDRegistered Dietitian
DT83980TXMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Bare Nutrition LLC CurrentSince May 1, 2020 Accepting new patients

Locations

1780 E University Ave
Las Cruces, NM 88003
Phone (575) 646-0111

1155 S Telshor Blvd
Ste 301
Las Cruces, NM 88011
Phone (505) 330-0329

1180 Commerce Dr
Unit 13880
Las Cruces, NM 88013

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1245851369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "C/O BBP SERVICES LLC",
            "address_2": "1180 COMMERCE DR UNIT 13880",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880134636",
            "telephone_number": "575-649-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 S TELSHOR BLVD STE 301",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114757",
            "telephone_number": "575-649-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESQUIBEL",
        "first_name": "AMANDA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-29",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT83980",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NM",
            "license": "LD-1050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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.