Active NPI
Amberlee C. Himebaugh
- Pediatric Nutrition Registered Dietitian
- Dallas, TX
National Provider Identifier
1821345174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nutrition Registered Dietitian
- License
- DT82079
- Practice address
- 1935 Medical District Dr
Clinical Nutrition
Dallas, TX 75235 - Phone
- (214) 456-2701
- Fax
- (214) 456-6287
- NPI assigned
- Aug 6, 2012
- 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 |
|---|---|---|---|---|
| Pediatric Nutrition Registered Dietitian | 133VN1004X | DT82079 | TX | Primary |
Addresses
Primary practice location
1935 Medical District Dr
Clinical Nutrition
Dallas, TX 75235
Mailing address
1935 Medical District Dr
Clinical Nutrition
Dallas, TX 75235
Phone (214) 456-2701
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 |
|---|---|---|---|
| DT82079 | TX | MD | Pediatric Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344211200000",
"number": "1821345174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1935 MEDICAL DISTRICT DR",
"address_2": "CLINICAL NUTRITION",
"city": "DALLAS",
"state": "TX",
"postal_code": "75235",
"telephone_number": "214-456-2701",
"fax_number": "214-456-6287"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1935 MEDICAL DISTRICT DR",
"address_2": "CLINICAL NUTRITION",
"city": "DALLAS",
"state": "TX",
"postal_code": "75235",
"telephone_number": "214-456-2701",
"fax_number": "214-456-6287"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIMEBAUGH",
"first_name": "AMBERLEE",
"middle_name": "C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-06",
"last_updated": "2012-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "TX",
"license": "DT82079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.