Amy McCallister, R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

875272 Issued in AZ

Practice address

18001 N 79TH Ave Ste A12
Glendale, AZ 85308

Phone

(623) 399-6825

Fax

(623) 505-3474

NPI assigned

Jan 3, 2007

Last updated

Mar 2, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ, NV, OR3 enrollments

Enrollment records 3

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Am Nutrition ServicesGroup PAC ID 1254430580, 48 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Am Nutrition Services

  • Registered Dietitian
  • Glendale, AZ
  • NPI 1003011602

  Dietitian, Registered, NV

  Medicare reassignment Care Compare group NPD Authorized official
• Amns Oregon, LLC

  • Registered Dietitian
  • Portland, OR
  • NPI 1619867835

  Dietitian, Registered

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1710044011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18001 N 79TH AVE STE A12",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088398",
            "telephone_number": "623-399-6825",
            "fax_number": "623-505-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18001 N 79TH AVE STE A12",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "623-399-6825",
            "fax_number": "623-505-3474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14045 N 7th St Ste 4",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850224387",
            "country_code": "US",
            "telephone_number": "623-399-6825",
            "fax_number": "623-505-3474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4653 E Cotton Gin Loop Ste 100",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850408835",
            "country_code": "US",
            "telephone_number": "623-399-6825",
            "fax_number": "623-505-3474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10750 W McDowell Rd Ste A300",
            "address_purpose": "LOCATION",
            "city": "Avondale",
            "state": "AZ",
            "postal_code": "853925963",
            "country_code": "US",
            "telephone_number": "623-399-6825",
            "fax_number": "623-505-3474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3815 E Bell Rd # 4250",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850322122",
            "country_code": "US",
            "telephone_number": "623-399-6825",
            "fax_number": "623-505-3474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCALLISTER",
        "first_name": "AMY",
        "name_prefix": "Ms.",
        "credential": "R.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "875272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "819625",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "Z115444",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darrelan Michelle McBride, FNP-C
• Randall McBride, LCSW
• Cody McBroom
• Crystal Lynn McCabe, PH.D.
• Austin McCall, PSYD
• Patricia Leigh McCarthy, ABOC, NCLEC, LDO
• Kathaleen McCausland
• Denise Michelle McClain, FNP-C
• Kaylee McClaine, BCBA
• Donna McClellan

• Registered Dietitian in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Registered Dietitian in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; 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.