Active NPI
Amaryllis D McKeag, RD, LDN
- Registered Dietitian
- Providence, RI
National Provider Identifier
1629265103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LDN00593
- Practice address
- 825 Chalkstone Ave
Providence, RI 02908-4728 - Phone
- (401) 456-4015
- NPI assigned
- Sep 28, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | LDN00593 | RI | Primary |
Addresses
Primary practice location
825 Chalkstone Ave
Providence, RI 02908-4728
Mailing address
825 Chalkstone Ave
Providence, RI 02908-4728
Phone (401) 456-2000
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LDN00593 | RI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267142400000",
"number": "1629265103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 CHALKSTONE AVE",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029084728",
"telephone_number": "401-456-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 CHALKSTONE AVE",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029084728",
"telephone_number": "401-456-4015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKEAG",
"first_name": "AMARYLLIS",
"middle_name": "D",
"name_prefix": "Miss",
"credential": "RD, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-28",
"last_updated": "2010-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "RI",
"license": "LDN00593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.