Active NPI
Amanda Nicole Nadeau, MS, RD, LD
- Registered Dietitian
- Atlanta, GA
National Provider Identifier
1528653763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86088276
- Practice address
- 1364 Clifton Rd NE
Atlanta, GA 30322-2779 - Phone
- (704) 654-0336
- NPI assigned
- Mar 9, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86088276 | Primary |
Addresses
Primary practice location
1364 Clifton Rd NE
Atlanta, GA 30322-2779
Mailing address
4043 Port Springs TRL
Snellville, GA 30039-5447
Phone (704) 654-0336
Other practice location 1
4043 Port Springs Trl
Snellville, GA 30039-5447
Phone (704) 654-0336
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696291200000",
"number": "1528653763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4043 PORT SPRINGS TRL",
"city": "SNELLVILLE",
"state": "GA",
"postal_code": "300395447",
"telephone_number": "704-654-0336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1364 CLIFTON RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303222779",
"telephone_number": "704-654-0336"
}
],
"practiceLocations": [
{
"address_1": "4043 Port Springs Trl",
"address_purpose": "LOCATION",
"city": "Snellville",
"state": "GA",
"postal_code": "300395447",
"country_code": "US",
"telephone_number": "704-654-0336",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NADEAU",
"first_name": "AMANDA",
"middle_name": "NICOLE",
"name_prefix": "Ms.",
"credential": "MS, RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-09",
"last_updated": "2023-10-03",
"certification_date": "2023-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "86088276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.