Individual provider Active NPI

Amanda Ruth Harkless, RD

  • Registered Dietitian
  • Frederick, MD
National Provider Identifier
1518620111
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DX3414 Issued in MD
Practice address
400 W 7TH St
Food and Nutrition
Frederick, MD 21701-4506
Phone
(240) 566-3885
NPI assigned
Oct 20, 2021
Last updated
Oct 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DX3414 MD Primary
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X DX3414 MD
Oncology Nutrition Registered Dietitian 133VN1301X DX3414 MD

Addresses

Primary practice location

400 W 7TH St
Food and Nutrition
Frederick, MD 21701-4506

Mailing address

400 W 7TH St
Food and Nutrition
Frederick, MD 21701-4506
Phone (240) 566-3885

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

LicenseStateTypeSpecialty
DX3414MDMDOncology Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1518620111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W 7TH ST",
            "address_2": "FOOD AND NUTRITION",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014506",
            "telephone_number": "240-566-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 7TH ST",
            "address_2": "FOOD AND NUTRITION",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014506",
            "telephone_number": "240-566-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARKLESS",
        "first_name": "AMANDA",
        "middle_name": "RUTH",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-20",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "DX3414",
            "primary": true
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "MD",
            "license": "DX3414",
            "primary": false
        },
        {
            "code": "133VN1301X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Oncology",
            "state": "MD",
            "license": "DX3414",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.