Amanda L Conklin, MS, RD, LDN, CNSC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND10545 Issued in FL

Practice address

4001 New Broad Cir Apt 113
Oviedo, FL 32765-7359

Phone

(689) 262-0597

NPI assigned

Jan 26, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grand Strand Surgical Specialists LLCGroup PAC ID 4082770656, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Grand Strand Surgical Specialists, LLC

  • Surgery Physician
  • Myrtle Beach, SC
  • NPI 1841465804
  Medicare reassignment Care Compare group
• Fay Nutrition

  • Registered Dietitian
  • San Francisco, CA
  • NPI 1104334465

  Dietitian, Registered

  NPD (past)
• Marjorie Nolan Cohn LLC

  • Registered Dietitian
  • New York, NY
  • NPI 1760825160

  Dietitian, Registered

  NPD (past)
• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1700157419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 NEW BROAD CIR APT 113",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327657359",
            "telephone_number": "689-262-0597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 NEW BROAD CIR APT 113",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327657359",
            "telephone_number": "689-262-0597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "AMANDA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MS, RD, LDN, CNSC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-26",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L006492",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND10545",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN004677",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SC",
            "license": "3651",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Advancement Development, Inc.
• Community Life Development
• Complete Care Centers, LLC
• Darice Concepcion, RBT
• Confirmative Management Services, LLC
• Melanie Connatser, PTA
• Haley Amanda Conner, DO
• Landrie Lane Connery, COTA/L
• Ashli Conrad
• Dana Conrad

• Registered Dietitian in Oviedo, FL
• Providers in Oviedo, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.