Amber Odom Nutrition, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

AMBER ODOM NUTRITION, LLC

Practice address

2560 King Arthur Blvd Ste 124-1
Lewisville, TX 75056-5921

Phone

(469) 223-2602

NPI assigned

Jan 19, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Amber Renee Odom, RDN, LDNPI 1568064673

Title

Registered Dietitian

Phone

(469) 223-2602

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amber Renee Odom, RDN, LD

  • Registered Dietitian
  • Lewisville, TX
  • NPI 1568064673

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1437801636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 KING ARTHUR BLVD STE 124-1",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750565921",
            "telephone_number": "469-223-2602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 KING ARTHUR BLVD STE 124-1",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750565921",
            "telephone_number": "469-223-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBER ODOM NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-19",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "ODOM",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "469-223-2602",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RDN, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rdn@amberodom.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "business email",
            "address_1": "2560 King Arthur Blvd Ste 124-1",
            "city": "Lewisville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750565921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Registered Dietitian in Lewisville, TX
• Providers in Lewisville, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.