Amy Cornelius

Individual provider Active NPI Registered Dietitian · Saltillo, MS

NPI 1922791920 · NPPES record last updated May 26, 2023

Key facts

NPI
1922791920
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
D0582 (MS)
Practice address
379 Mobile Street
Saltillo, MS 38866
Phone
(662) 869-3700
NPI assigned
May 26, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
D0582MSMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrition Care LLC Current
since May 28, 2023
Accepting new patients
Nutrition Care LLC Dietitian, Registered Past
since May 28, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X D0582 MS Yes

Addresses

Primary practice location

379 Mobile Street
Saltillo, MS 38866

Mailing address

PO Box 79
Saltillo, MS 38866-0079
Phone (662) 869-3700

Other providers in Saltillo, MS

All providers in Saltillo, MS · Registered Dietitian in Mississippi

Sources for this page

Verify at the official NPI Registry.