Active NPI
Amanda Ettinger, RD
- Registered Dietitian
- Lewiston, ME
National Provider Identifier
1902159254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- TD1124
- Practice address
- 10 High St
Ste. 105
Lewiston, ME 04240-7653 - Phone
- (207) 795-5710
- Fax
- (207) 795-2559
- NPI assigned
- Oct 24, 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 | TD1124 | ME | Primary |
Addresses
Primary practice location
10 High St
Ste. 105
Lewiston, ME 04240-7653
Mailing address
10 High St
Ste. 105
Lewiston, ME 04240-7653
Phone (207) 795-5710
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TD1124 | ME | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amanda Ettinger Nutrition LLC | Dietitian, Registered | Current | 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": "1351036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351036800000",
"number": "1902159254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 HIGH ST",
"address_2": "STE. 105",
"city": "LEWISTON",
"state": "ME",
"postal_code": "042407653",
"telephone_number": "207-795-5710",
"fax_number": "207-795-2559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 HIGH ST",
"address_2": "STE. 105",
"city": "LEWISTON",
"state": "ME",
"postal_code": "042407653",
"telephone_number": "207-795-5710",
"fax_number": "207-795-2559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETTINGER",
"first_name": "AMANDA",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-24",
"last_updated": "2012-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ME",
"license": "TD1124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewiston, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.