Amy Henderson, RD, MS, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1719 Issued in OK

Practice address

10306 N 138TH East Ave
Suite 204
Owasso, OK 74055-4665

Phone

(918) 401-0006

Fax

(877) 380-4628

NPI assigned

Sep 5, 2014

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

Other names 1

• Amy Ruskoski Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

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.

• Nutrition Resources PLC

  • Registered Dietitian
  • Owasso, OK
  • NPI 1710235312

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1821499153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5662 S 83RD EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741457922",
            "telephone_number": "918-902-5611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10306 N 138TH EAST AVE",
            "address_2": "SUITE 204",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554665",
            "telephone_number": "918-401-0006",
            "fax_number": "877-380-4628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "AMY",
        "name_prefix": "Mrs.",
        "credential": "RD, MS, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-05",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "1719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "RUSKOSKI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hearing Lab Technology
• Mary Hegenbart, MS, CCC-SLP
• Catherane Helm, LMSW-P
• Jon Heltcel
• Sarina Helton, FNP
• James Aaron Henley, D.O.
• Martha Hernandez
• Rocio Hernandez
• Blake Hettick
• Amanda Hickman, M.ED.

• Registered Dietitian in Owasso, OK
• Providers in Owasso, OK by specialty
• Registered Dietitian in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; 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.