Active NPI
Amy Reynolds, RDN
- Registered Dietitian
- Baltimore, MD
National Provider Identifier
1770039802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86017272
- Practice address
- 25 N Chester St
Baltimore, MD 21231-1626 - Phone
- (434) 987-5376
- NPI assigned
- Aug 29, 2016
- Sex
- Female
- Sole proprietor
- No
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 | 86017272 | AZ | Primary |
Addresses
Primary practice location
25 N Chester St
Baltimore, MD 21231-1626
Mailing address
8401 Mayland Dr Ste V
Richmond, VA 23294-4648
Phone (434) 987-5376
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86017272 | AZ | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nutrition Therapy & Wellness Co. | Dietitian, Registered | Current | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Locations
8401 Mayland Dr
Ste V
Richmond, VA 23294
Phone (910) 803-3633
Organizations & group practices 2
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.
-
- Registered Dietitian
- Baltimore, MD
- NPI 1417786211
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722297600000",
"number": "1770039802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8401 MAYLAND DR STE V",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232944648",
"telephone_number": "434-987-5376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 N CHESTER ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212311626",
"telephone_number": "434-987-5376"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "AMY",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-29",
"last_updated": "2024-07-30",
"certification_date": "2024-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AZ",
"license": "86017272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.