Individual provider Active NPI

Amy L. Witterschein, RD

  • Registered Dietitian
  • Elizabeth, NJ
National Provider Identifier
1972919884
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
NOTAPPLICABLE Issued in NJ
Practice address
433 N Broad St
Elizabeth, NJ 07208-3300
Phone
(908) 436-1002
Fax
(908) 436-1109
NPI assigned
Jul 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NOTAPPLICABLE NJ Primary

Addresses

Primary practice location

433 N Broad St
Elizabeth, NJ 07208-3300

Mailing address

234 Hillside Ave
Springfield, NJ 07081-2810
Phone (845) 649-2491

Other practice location 1

19 Prospect St
South Orange, NJ 07079-2218
Phone (973) 544-8649

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

LicenseStateTypeSpecialty
NOTAPPLICABLENJMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Mejia Pediatrics LLC Past Accepting new patients
Advocare, LLC Past Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1972919884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 HILLSIDE AVE",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070812810",
            "telephone_number": "845-649-2491",
            "fax_number": "908-436-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 N BROAD ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083300",
            "telephone_number": "908-436-1002",
            "fax_number": "908-436-1109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Prospect St",
            "address_purpose": "LOCATION",
            "city": "South Orange",
            "state": "NJ",
            "postal_code": "070792218",
            "country_code": "US",
            "telephone_number": "973-544-8649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITTERSCHEIN",
        "first_name": "AMY",
        "middle_name": "L.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-11",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NJ",
            "license": "NOTAPPLICABLE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.