Active NPI
Amanda Bosch, MS, RDN
- Registered Dietitian
- Wyoming, MI
National Provider Identifier
1881423291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86434051
- Practice address
- 5900 Byron Center Ave SW
Wyoming, MI 49519-9606 - Phone
- (616) 252-7083
- NPI assigned
- Aug 1, 2024
- Last updated
- Aug 1, 2024
- 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 | 86434051 | MI | Primary |
Addresses
Primary practice location
5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Mailing address
5900 Byron Center Ave SW
Wyoming, MI 49519-9606
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86434051 | MI | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722470400000",
"number": "1881423291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5900 BYRON CENTER AVE SW",
"city": "WYOMING",
"state": "MI",
"postal_code": "495199606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 BYRON CENTER AVE SW",
"city": "WYOMING",
"state": "MI",
"postal_code": "495199606",
"telephone_number": "616-252-7083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSCH",
"first_name": "AMANDA",
"credential": "MS, RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-01",
"last_updated": "2024-08-01",
"certification_date": "2024-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MI",
"license": "86434051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.