Amanda Ellen Averett, MS, RDN, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

L005831 Issued in NC

Practice address

19607 W Catawba Ave Ste 102
Cornelius, NC 28031-4042

Phone

(919) 603-7631

NPI assigned

Jul 11, 2019

Last updated

Jul 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1720630585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 BENTRIDGE DR NW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280272826",
            "telephone_number": "919-603-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19607 W CATAWBA AVE STE 102",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314042",
            "telephone_number": "919-603-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERETT",
        "first_name": "AMANDA",
        "middle_name": "ELLEN",
        "credential": "MS, RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L005831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gregory Thomas Badway, RPH
• Jodie Bailey, LMBT, MLD-C, CST
• Sarah Baird
• Balanced Mind, PLLC.

• Registered Dietitian in Cornelius, NC
• Providers in Cornelius, NC by specialty
• Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.

Verify at the official NPI Registry.