Individual provider Active NPI

Amanda Mee Gibbs, MS RD CDN

  • Registered Dietitian
  • Malone, NY
National Provider Identifier
1659259364
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
008919 Issued in NY
Practice address
133 Park St
Malone, NY 12953-1244
Phone
(315) 406-6217
NPI assigned
Aug 22, 2025
Last updated
Dec 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 008919 NY
Registered Dietitian 133V00000X 008919 NY Primary

Addresses

Primary practice location

133 Park St
Malone, NY 12953-1244

Mailing address

PO Box 175
Ray Brook, NY 12977-0175
Phone (315) 406-6217

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251211000417 NY Practitioner - Registered Dietitian Or Nutrition Professional 7810481413 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 1150
Burlington, VT 05402

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008919NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Alice Hyde Medical Center CurrentSince Nov 1, 2025 Accepting new patients
Alice Hyde Medical Center CurrentSince Nov 1, 2025 Accepting new patients
Alice Hyde Medical Center Past Accepting new patients

Locations

969 State Route 11
Moira, NY 12957
Phone (518) 529-7847

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1755820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1659259364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 175",
            "city": "RAY BROOK",
            "state": "NY",
            "postal_code": "129770175",
            "telephone_number": "315-406-6217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 PARK ST",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129531244",
            "telephone_number": "315-406-6217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "AMANDA",
        "middle_name": "MEE",
        "credential": "MS RD CDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-22",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NY",
            "license": "008919",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "008919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malone, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.