Andrea Beth Bontrager Yoder, PHD, RDN, CD

Individual provider Active NPI Registered Dietitian · Elkhart, IN

NPI 1487217352 · NPPES record last updated Mar 31, 2021

Key facts

NPI
1487217352
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
37002566A (IN)
Practice address
1627 E Bristol St
Elkhart, IN 46514-3817
Phone
(574) 262-0313
Fax
(574) 389-4879
NPI assigned
Apr 17, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 37002566A IN Yes

Addresses

Primary practice location

1627 E Bristol St
Elkhart, IN 46514-3817

Mailing address

710 N Niles Ave
South Bend, IN 46617-1924
Phone (574) 647-1610

Other identifiers

IdentifierTypeStateIssuer
236040319OtherINMEDICARE PTAN

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address abontrageryoder@mybeacon.cernerdirect.com

Other providers in Elkhart, IN

All providers in Elkhart, IN · Registered Dietitian in Indiana

Sources for this page

Verify at the official NPI Registry.