Individual provider Active NPI

Amanda Cerra, RDN, LDN

  • Registered Dietitian
  • Philadelphia, PA
National Provider Identifier
1982259131
Registry record updated Aug 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L004709 Issued in NC
Practice address
1512 South St FL 1
Philadelphia, PA 19146-1636
Phone
(267) 239-5697
NPI assigned
Aug 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2019

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 L004709 NC Primary

Addresses

Primary practice location

1512 South St FL 1
Philadelphia, PA 19146-1636

Mailing address

115 Christina Landing Dr Apt 1707
Wilmington, DE 19801-5472
Phone (607) 206-5720

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L004709NCMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1982259131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 CHRISTINA LANDING DR APT 1707",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198015472",
            "telephone_number": "607-206-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 SOUTH ST FL 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461636",
            "telephone_number": "267-239-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERRA",
        "first_name": "AMANDA",
        "credential": "RDN, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-05",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L004709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; 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.