Active NPI
Angelette Amanda Lovell, RDN
- Registered Dietitian
- Idaho Falls, ID
National Provider Identifier
1477366482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D-1072
- Practice address
- 2327 Coronado St
Idaho Falls, ID 83404-7407 - Phone
- (208) 528-1000
- NPI assigned
- Jan 31, 2025
- 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 | D-1072 | ID | Primary |
Addresses
Primary practice location
2327 Coronado St
Idaho Falls, ID 83404-7407
Mailing address
2343 Andrew St
Pocatello, ID 83201-7913
Phone (801) 928-9819
Other names 1
- Angelette Amanda Nilsson
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-1072 | ID | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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": "1738281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738281600000",
"number": "1477366482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2343 ANDREW ST",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832017913",
"telephone_number": "801-928-9819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2327 CORONADO ST",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834047407",
"telephone_number": "208-528-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOVELL",
"first_name": "ANGELETTE",
"middle_name": "AMANDA",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-31",
"last_updated": "2025-01-31",
"certification_date": "2025-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ID",
"license": "D-1072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANGELETTE",
"last_name": "NILSSON",
"middle_name": "AMANDA",
"credential": "RD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.