Individual provider Active NPI

Amy Fennel, RD, LD

  • Registered Dietitian
  • Murray, KY
National Provider Identifier
1619012390
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1291 Issued in KY
Practice address
803 Poplar St
Murray, KY 42071-2432
Phone
(270) 762-1558
Fax
(270) 762-1825
NPI assigned
Feb 21, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 1291 KY Primary

Addresses

Primary practice location

803 Poplar St
Murray, KY 42071-2432

Mailing address

204 Edgewood Dr
Murray, KY 42071-5663
Phone (270) 436-2146

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

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1619012390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 EDGEWOOD DR",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420715663",
            "telephone_number": "270-436-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 POPLAR ST",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420712432",
            "telephone_number": "270-762-1558",
            "fax_number": "270-762-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNEL",
        "first_name": "AMY",
        "credential": "RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KY",
            "license": "1291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.