Amanda Ettinger Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

AMANDA ETTINGER NUTRITION LLC

Practice address

137 Riverside Dr
Auburn, ME 04210-6734

Phone

(207) 512-0982

NPI assigned

Feb 22, 2021

Organization subpart

No

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

Authorized official

Name

Amanda Ettinger, RD, LDNPI 1902159254

Title

Owner/Dietitian

Phone

(207) 512-0982

Specialties & licenses 1

Addresses

Practitioners 1

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

• Amanda Ettinger, RD

  • Registered Dietitian
  • Lewiston, ME
  • NPI 1902159254

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613952000000",
    "number": "1508450479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 RIVERSIDE DR",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042106734",
            "telephone_number": "207-512-0982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 RIVERSIDE DR",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042106734",
            "telephone_number": "207-512-0982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANDA ETTINGER NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-22",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "ETTINGER",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER/DIETITIAN",
        "authorized_official_telephone_number": "207-512-0982",
        "authorized_official_credential": "RD, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Shirley L. Ala, PA-C
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• Natalie Marie Antaya, PA-C

• Registered Dietitian in Auburn, ME
• Providers in Auburn, ME by specialty
• Registered Dietitian in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.

Verify at the official NPI Registry.