Individual provider Active NPI

Amy Good, RD, LD

  • Registered Dietitian
  • Yarmouth, ME
National Provider Identifier
1275905853
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
7627 Issued in OH
Practice address
253 Main St
Yarmouth, ME 04096-6800
Phone
(207) 387-1590
Fax
(866) 519-6015
NPI assigned
Oct 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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 7627 OH Primary

Addresses

Primary practice location

253 Main St
Yarmouth, ME 04096-6800

Mailing address

PO Box 292
Holland, OH 43528-0292
Phone (419) 405-3663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, HI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240118001713 TX Practitioner - Registered Dietitian Or Nutrition Professional 5698028058 Reassigns benefits to 1 organization
I20241009000000 HI Practitioner - Registered Dietitian Or Nutrition Professional 5698028058 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7627OHMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
The Queen'S Medical Center CurrentSince Aug 1, 2024 Accepting new patients
The Queens Medical Center CurrentSince Aug 1, 2024 Accepting new patients
Primary Care Physician Enterprise LLC CurrentSince Aug 1, 2024 Accepting new patients
Nourish, Inc. Dietitian, Registered CurrentSince Jan 8, 2024 Accepting new patients
The Queens Medical Center - Progressive Care Unit Past Accepting new patients
Queens University Medical Group Past Accepting new patients
Medical University of Ohio at Toledo Past Accepting new patients

Locations

515 S Flower St
#1015
Los Angeles, CA 90071

91-6390 Kapolei Pkwy
Ste 200
Ewa Beach, HI 96706
Phone (612) 802-2986

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

1380 Lusitana St
Ste 300
Honolulu, HI 96813
Phone (808) 691-4202

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

401 N Michigan Ave
Ste 1200
Chicago, IL 60611
Phone (224) 496-6940

500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000

3724 Jefferson St
Ste 104
Austin, TX 78731
Phone (512) 399-9039

Organizations & group practices 7

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": "1445472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1275905853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 292",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435280292",
            "telephone_number": "419-405-3663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 MAIN ST",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "040966800",
            "telephone_number": "207-387-1590",
            "fax_number": "866-519-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOD",
        "first_name": "AMY",
        "credential": "RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-22",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "7627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yarmouth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.