Active NPI
Amanda Mellowspring, MS,RD,CEDRD
- Registered Dietitian
- Blacksburg, VA
National Provider Identifier
1881136612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 953736
- Practice address
- 708 S Main St
Blacksburg, VA 24060-5210 - Phone
- (540) 505-4663
- Fax
- (540) 953-5095
- NPI assigned
- Nov 10, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 953736 | Primary |
Addresses
Primary practice location
708 S Main St
Blacksburg, VA 24060-5210
Mailing address
708 S Main St
Blacksburg, VA 24060-5210
Phone (540) 505-4663
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
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Altitude Iop, LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478736000000",
"number": "1881136612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "708 S MAIN ST",
"city": "BLACKSBURG",
"state": "VA",
"postal_code": "240605210",
"telephone_number": "540-505-4663",
"fax_number": "540-953-5095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "708 S MAIN ST",
"city": "BLACKSBURG",
"state": "VA",
"postal_code": "240605210",
"telephone_number": "540-505-4663",
"fax_number": "540-953-5095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELLOWSPRING",
"first_name": "AMANDA",
"credential": "MS,RD,CEDRD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-10",
"last_updated": "2016-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "953736",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blacksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.