Amy Dawn Ellis, MS, RD, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD-0750 Issued in NM

Practice address

Highway 169 Mile Marker 29
Alamo, NM 87825-5907

Phone

(575) 854-2642

Fax

(575) 854-2606

NPI assigned

Aug 31, 2012

Last updated

Aug 31, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alamo Navajo School Board, Inc.

  dba alamo navajo health center

  • Primary Care Clinic/Center
  • Alamo, NM
  • NPI 1861412777
  NPD (past)

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

{
    "created_epoch": "1346371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1861741241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5907",
            "address_2": "HIGHWAY 169 MILE MARKER 29",
            "city": "ALAMO",
            "state": "NM",
            "postal_code": "878255907",
            "telephone_number": "575-854-2642",
            "fax_number": "575-854-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HIGHWAY 169 MILE MARKER 29",
            "city": "ALAMO",
            "state": "NM",
            "postal_code": "878255907",
            "telephone_number": "575-854-2642",
            "fax_number": "575-854-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "AMY",
        "middle_name": "DAWN",
        "credential": "MS, RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-31",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NM",
            "license": "LD-0750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alamo Navajo School Board, Inc. (alamo navajo health center)
• Lorena Crank, M.S.W.
• Karagan Romoser, LCSW, MSW
• Tsigabu Seyoum, PHARMD
• Sharyl M Trail, PSYD
• Kibrom Mahray Woress, PHARMD
• Tsehaye K Zemenfes, PHARMD

• Registered Dietitian in Alamo, NM
• Providers in Alamo, NM by specialty
• Registered Dietitian in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.

Verify at the official NPI Registry.