Individual provider Active NPI

Amelia Quigley, MS

  • Registered Dietitian
  • Riverside, CA
National Provider Identifier
1518503382
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
5332 Issued in MA
Practice address
1650 Spruce St Ste 205
Riverside, CA 92507-7402
Phone
(760) 815-7772
NPI assigned
Nov 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Registered Dietitian 133V00000X 5332 MA Primary

Addresses

Primary practice location

1650 Spruce St Ste 205
Riverside, CA 92507-7402

Mailing address

6 Howland St Apt 4
Middleboro, MA 02346-2554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220428002296 MA Practitioner - Registered Dietitian Or Nutrition Professional 9931596590 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
5332MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Brockton Neighborhood Health Center, Inc. CurrentSince Feb 10, 2022 Accepting new patients
Brockton Neighborhood Health Center CurrentSince Feb 10, 2022 Accepting new patients
Brockton Neighborhood Health Center Current Accepting new patients

Locations

63 Main St
Brockton, MA 02301
Phone (508) 559-6696

Interoperability endpoints

  • FHIR API: https://epicproxy.et1290.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1518503382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HOWLAND ST APT 4",
            "city": "MIDDLEBORO",
            "state": "MA",
            "postal_code": "023462554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 SPRUCE ST STE 205",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925077402",
            "telephone_number": "760-815-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIGLEY",
        "first_name": "AMELIA",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-26",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "5332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.