Active NPI
Amanda Jane Petti, RD
- Registered Dietitian
- Iron Mountain, MI
National Provider Identifier
1831349539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 928012
- Practice address
- 300 E H Street
Nutrition & Food Service
Iron Mountain, MI 49801 - Phone
- (906) 774-3300
- NPI assigned
- Sep 30, 2008
- 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 | 928012 | Primary |
Addresses
Primary practice location
300 E H Street
Nutrition & Food Service
Iron Mountain, MI 49801
Mailing address
N1526 S Circle Dr
Norway, MI 49870-2000
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222732800000",
"number": "1831349539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N1526 S CIRCLE DR",
"city": "NORWAY",
"state": "MI",
"postal_code": "498702000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 E H STREET",
"address_2": "NUTRITION & FOOD SERVICE",
"city": "IRON MOUNTAIN",
"state": "MI",
"postal_code": "49801",
"telephone_number": "906-774-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTI",
"first_name": "AMANDA",
"middle_name": "JANE",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-30",
"last_updated": "2008-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "928012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Iron Mountain, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.