Individual provider Active NPI

Amy Lynn Broxterman, MS, RD, LD, CNSC

  • Registered Dietitian
  • Olathe, KS
National Provider Identifier
1497004121
Registry record updated Sep 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1356 Issued in KS
Practice address
20333 W 151St St
Olathe, KS 66061-5350
Phone
(913) 791-3500
NPI assigned
Sep 10, 2012
Last updated
Sep 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1356 KS Primary

Addresses

Primary practice location

20333 W 151St St
Olathe, KS 66061-5350

Mailing address

20333 W 151St St
Olathe, KS 66061-5350
Phone (913) 791-3500

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

State licenses

LicenseStateTypeSpecialty
1356KSMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1497004121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20333 W 151ST ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660615350",
            "telephone_number": "913-791-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20333 W 151ST ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660615350",
            "telephone_number": "913-791-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROXTERMAN",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "credential": "MS, RD, LD, CNSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-10",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KS",
            "license": "1356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; 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.