Active NPI
Tricia Amundson, RD
- Registered Dietitian
- Racine, WI
National Provider Identifier
1720425218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2389-29
- Practice address
- 1927 Sunnyslope Drive
Racine, WI 53406 - Phone
- (920) 787-8912
- NPI assigned
- May 24, 2013
- Last updated
- Jul 30, 2019
- 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 | 2389-29 | WI | Primary |
Addresses
Primary practice location
1927 Sunnyslope Drive
Racine, WI 53406
Mailing address
1927 N Sunnyslope Dr
Mount Pleasant, WI 53406-7671
Phone (920) 737-8912
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2389-29 | WI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564444800000",
"number": "1720425218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1927 N SUNNYSLOPE DR",
"city": "MOUNT PLEASANT",
"state": "WI",
"postal_code": "534067671",
"telephone_number": "920-737-8912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1927 SUNNYSLOPE DRIVE",
"city": "RACINE",
"state": "WI",
"postal_code": "53406",
"telephone_number": "920-787-8912"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMUNDSON",
"first_name": "TRICIA",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-24",
"last_updated": "2019-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "2389-29",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Racine, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.