Active NPI
Amanda Kischuk
- Registered Dietitian
- Garden City, MI
National Provider Identifier
1841545811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1040941
- Practice address
- 6245 Inkster Rd
Garden City, MI 48135-4001 - Phone
- (734) 458-3300
- NPI assigned
- Jul 17, 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1040941 | MI | Primary |
Addresses
Primary practice location
6245 Inkster Rd
Garden City, MI 48135-4001
Mailing address
3044 Lincoln St
Dearborn, MI 48124-3504
Phone (313) 570-4271
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1040941 | Other | MI | CDR NUMBER |
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 |
|---|---|---|---|
| 1040941 | MI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342483200000",
"number": "1841545811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3044 LINCOLN ST",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481243504",
"telephone_number": "313-570-4271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6245 INKSTER RD",
"city": "GARDEN CITY",
"state": "MI",
"postal_code": "481354001",
"telephone_number": "734-458-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISCHUK",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-17",
"last_updated": "2012-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MI",
"license": "1040941",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDR NUMBER",
"identifier": "1040941",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Garden City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.