Active NPI
Amanda Rae Nelson, RD
- Registered Dietitian
- Yuma, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 2400 S Avenue a
Yuma, AZ 85364-7170 - Phone
- (928) 600-2047
- NPI assigned
- Sep 8, 2022
- Last updated
- Sep 8, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86170092 | WI | |
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
2400 S Avenue a
Yuma, AZ 85364-7170
Mailing address
3567 W 22ND PL Unit E
Yuma, AZ 85364-7623
Phone (262) 705-0147
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86170092 | WI | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adelante Healthcare, Inc. | Current | Accepting new patients | |
| Adelante Healthcare, Inc | Current | Accepting new patients | |
| Adelante Healthcare, Inc. | Current | Accepting new patients | |
| Mountain Park Health Center | Current | Accepting new patients | |
| Mountain Park Health Center | Current | Accepting new patients | |
| Mountain Park Health Center - Dental | Past | Accepting new patients |
Locations
6975 W Glendale Ave
Glendale, AZ 85303
Phone (480) 729-0905
140 N Litchfield Rd
Ste 200106
Goodyear, AZ 85338
Phone (623) 936-6795
13471 W Cornerstone Blvd
Goodyear, AZ 85395
Phone (844) 551-6691
140 N Litchfield Rd
Ste 106
Goodyear, AZ 85338
Phone (480) 861-6426
140 N Litchfield Rd
#200106
Goodyear, AZ 85338
3003 N Central Ave
Ste 1600
Phoenix, AZ 85012
Phone (602) 323-3492
6601 W Thomas Rd
Phoenix, AZ 85033
635 E Baseline Rd
Phoenix, AZ 85042
3033 N Central Ave
Ste 145
Phoenix, AZ 85012
15317 W Bell Rd
Ste 100
Surprise, AZ 85374
Organizations & group practices 7
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.
-
dba Phoenix Children's Medical Group
- Pediatrics Physician
- Phoenix, AZ
- NPI 1922112044
-
dba Adelante Healthcare-Roosevelt
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1215734124
-
dba Adelante Healthcare-Wickenburg
- Federally Qualified Health Center (FQHC)
- Wickenburg, AZ
- NPI 1083772545
-
dba Adelante Healthcare-Gila Bend
- Federally Qualified Health Center (FQHC)
- Gila Bend, AZ
- NPI 1386702942
-
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1386452415
-
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1558308825
-
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1710146188
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662595200000",
"number": "1952022725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3567 W 22ND PL UNIT E",
"city": "YUMA",
"state": "AZ",
"postal_code": "853647623",
"telephone_number": "262-705-0147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 S AVENUE A",
"city": "YUMA",
"state": "AZ",
"postal_code": "853647170",
"telephone_number": "928-600-2047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "AMANDA",
"middle_name": "RAE",
"name_prefix": "Ms.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-08",
"last_updated": "2022-09-08",
"certification_date": "2021-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "86170092",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Yuma, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.