Amanda Leanna Hellebusch, RD
Individual provider Active NPI Registered Dietitian · Washington, MO
NPI 1437794898 · NPPES record last updated Oct 9, 2023
Key facts
- NPI
- 1437794898
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 2019032534 (MO)
- Practice address
- 901 Patients First Dr Ste 2000
Washington, MO 63090-4700 - Phone
- (636) 390-1684
- NPI assigned
- Nov 8, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231011003171 | MO | Practitioner - Registered Dietitian Or Nutrition Professional | 5395190318 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Surgical Specialists, LLC | Current |
Accepting new patients | |
| Mercy Clinic East Communities | Current | Accepting new patients | |
| Mercy Clinic East Communities | Current |
Accepting new patients | |
| Mercy Hospitals East Communities | Past |
Accepting new patients |
Locations
621 S New Ballas Rd
Ste 3005B
Saint Louis, MO 63141
Phone (314) 251-7070
901 Patients First Dr
Ste 2000
Washington, MO 63090
Phone (636) 239-7344
851 E 5th St
Ste 108
Washington, MO 63090
Phone (636) 239-4144
851 E 5th St
Ste 328
Washington, MO 63090
Phone (636) 239-1101
901 Patients First Dr
Ste 2000A
Washington, MO 63090
Phone (636) 390-1776
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2019032534 | MO | Yes |
Addresses
Primary practice location
901 Patients First Dr Ste 2000
Washington, MO 63090-4700
Mailing address
PO Box 776084
Chicago, IL 60677-6084
Phone (636) 390-1684
Other names
- Amanda Leanna Martin
NPI Registry JSON
{
"created_epoch": "1573171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696809600000",
"number": "1437794898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 776084",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606776084",
"telephone_number": "636-390-1684",
"fax_number": "636-231-3644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 PATIENTS FIRST DR STE 2000",
"city": "WASHINGTON",
"state": "MO",
"postal_code": "630904700",
"telephone_number": "636-390-1684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HELLEBUSCH",
"first_name": "AMANDA",
"middle_name": "LEANNA",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-08",
"last_updated": "2023-10-09",
"certification_date": "2023-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MO",
"license": "2019032534",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "MARTIN",
"middle_name": "LEANNA",
"credential": "RD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Washington, MO
- Healthwest,LLC
- Healthy Home Health Care
- Kaylee Heil
- Amanda Heisel
- Rachel Nicole Heitman
- Dana L Hellebusch
- Emily A Helton
- Ronak Dana Hendry
- Branna Jo-Chapman Hensley
- Sara K Herbert
All providers in Washington, MO · Registered Dietitian in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.