Amanda Nack

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

970 Issued in ND

Practice address

736 Broadway N
Fargo, ND 58102

Phone

(701) 234-2000

Fax

(701) 234-2345

NPI assigned

Oct 10, 2018

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)

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 and National Provider Directory roles.

• Internal Medicine Associates Inc

  • Internal Medicine Physician
  • Fargo, ND
  • NPI 1144313743
  NPD
• 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": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1770058232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58102",
            "telephone_number": "701-234-2000",
            "fax_number": "701-234-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 University Dr S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581034940",
            "country_code": "US",
            "telephone_number": "701-461-5319",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1720 University Dr S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581034940",
            "country_code": "US",
            "telephone_number": "701-461-5319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NACK",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-10",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ND",
            "license": "970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myofascial Release by Katie
• Wendy Ann Myren
• Jason C Myrmoe, MD
• Briana R Myrvik, B. S.
• N.I.a.M Brain Injury Services, LLP
• Nivedita Sudhir Nadkarni, MD
• Helena Nagbe
• Brandon Sullivan Nagel, DPM
• Lisa K Nagel, PHARMD
• Amber Nicole Nagengast

• Registered Dietitian in Fargo, ND
• Providers in Fargo, ND by specialty
• Registered Dietitian in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; 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.