Individual provider Active NPI

Amanda Rae Nelson, RD

  • Registered Dietitian
  • Yuma, AZ
National Provider Identifier
1952022725
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
2400 S Avenue a
Yuma, AZ 85364-7170
Phone
(928) 600-2047
NPI assigned
Sep 8, 2022
Last updated
Sep 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

Enrollment IDStateProvider typePAC IDDetails
I20230621003592 AZ Practitioner - Registered Dietitian Or Nutrition Professional 1557729639 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86170092WIMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Adelante Healthcare, Inc. Current Accepting new patients
Adelante Healthcare, Inc CurrentSince Apr 24, 2023 Accepting new patients
Adelante Healthcare, Inc. CurrentSince Apr 24, 2023 Accepting new patients
Mountain Park Health Center CurrentSince Mar 29, 2024 Accepting new patients
Mountain Park Health Center CurrentSince Mar 29, 2024 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.

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.

Verify at the official NPI Registry.