Amber Pelletier Simon, RD, CLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86081222 Issued in CO

Practice address

1039 Oak Cir
Lakewood, CO 80215-4535

Phone

(860) 214-0139

NPI assigned

Oct 27, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Amber Marie Pelletier Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1881358745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2890 S FAIRFAX ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802226839",
            "telephone_number": "860-214-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 OAK CIR",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802154535",
            "telephone_number": "860-214-0139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2890 S Fairfax St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802226839",
            "country_code": "US",
            "telephone_number": "860-214-0139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "AMBER",
        "middle_name": "PELLETIER",
        "credential": "RD, CLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "CO",
            "license": "311226",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CO",
            "license": "86081222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "PELLETIER",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nicole Silverman, BCBA
• Silvia Speech Therapy LLC
• Leslye Simental-Alvarado, RBT
• Takayla Lanae Simes
• Lydia Simmons, LPC, CAC II
• Bradley Eric Simon, MD
• Suzanne Elaine Simone, MSN, APRN, CPNP-PC
• James R Simons, BC-HIS
• Mariah Simonton, MT
• Simple Smiles, PLLC

• Registered Dietitian in Lakewood, CO
• Providers in Lakewood, CO by specialty
• Registered Dietitian in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.