Active NPI
Amanda Bakko, MS RDN
- Registered Dietitian
- Norfolk, VA
National Provider Identifier
1457017113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 6340 Center Dr
Norfolk, VA 23502-4104 - Phone
- (703) 466-5150
- NPI assigned
- Nov 16, 2021
- Last updated
- Nov 16, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
6340 Center Dr
Norfolk, VA 23502-4104
Mailing address
6340 Center Dr
Norfolk, VA 23502-4104
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 86075402 | Other | VA | AND |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | amandab@prosperityedwell.com |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637020800000",
"number": "1457017113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6340 CENTER DR",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235024104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6340 CENTER DR",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235024104",
"telephone_number": "703-466-5150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKKO",
"first_name": "AMANDA",
"credential": "MS RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-16",
"last_updated": "2021-11-16",
"certification_date": "2021-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AND",
"identifier": "86075402",
"state": "VA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "amandab@prosperityedwell.com",
"affiliation": "N",
"address_1": "6340 Center Dr",
"city": "Norfolk",
"state": "VA",
"country_code": "US",
"postal_code": "235024104",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.