Amy M Bragagnini, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

886364

Practice address

630 Kenmoor Ave SE
Suite 103
Grand Rapids, MI 49546

Phone

(616) 600-4950

Fax

(855) 817-3028

NPI assigned

Sep 7, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: amy.bragagnini.1@20679.direct.athenahealth.com

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1336696459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 KENMOOR AVE SE",
            "address_2": "SUITE 103",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49546",
            "telephone_number": "203-688-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 KENMOOR AVE SE",
            "address_2": "SUITE 103",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49546",
            "telephone_number": "616-600-4950",
            "fax_number": "855-817-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAGAGNINI",
        "first_name": "AMY",
        "middle_name": "M",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "886364",
            "primary": true
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "CT",
            "license": "1439",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "YNHH MEDICARE NUMBER",
            "identifier": "C02658",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ann Brady, LMSW
• Catherine A Brady
• Kristy Lynn Brady
• Randall Lee Brady, PA
• Justine Braford, BS
• Allen C Bragdon, MD
• Talawnda L Bragg, MD
• Elisabeth Brail, LMSW
• Brain Trauma Recovery Institute, PLC
• Brainstim LLC

• Registered Dietitian in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Registered Dietitian in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.