AMY HANNEKE (NPI# 1033638952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033638952 |
| Entity Type | Individual |
| Full Name | AMY HANNEKE |
| Other Name | AMY LEE |
| Credential | RDN, LD |
| Practice Address |
320 Ashland St. Apt. 1 Soda Springs ID 83276-8327 |
| Mailing Address |
164 S. 5th St. Montpelier ID 83254 |
| Practice Telephone | 3145916429 |
| Mailing Telephone | 2088471630 |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2018-03-20 |
| NPI Deactivation Date | 03/07/2018 |
| NPI Reactivation Date | 2018-03-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| Street Address |
320 ASHLAND ST. APT. 1 |
| City | SODA SPRINGS |
| State | ID |
| Zip Code | 83276-8327 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811390248 | Terry Lee Christensen | Physical Therapy Assistant | 279 E. 3rd N., Soda Springs, ID 83276 | 2014-09-30 |
| 1285049387 | Matthew F Kunz | Dentist | 180 S. Main Street, Soda Springs, ID 83276 | 2014-06-26 |
| 1801086012 | Caribou Memorial Hospital | Specialist | 300 South 3rd West, Soda Springs, ID 83276 | 2007-07-25 |
| 1386681427 | Eron J Evans | Dentist | 390 S 3rd W, Mountain View Dental, Soda Springs, ID 83276 | 2006-05-31 |
| 1154310373 | Jerry H Walker | Dentist | 390 South 3rd West, Soda Springs, ID 83276 | 2005-10-20 |
| 1184022105 | Inner Light Counseling, LLC | Social Worker | 61 E 1st S, Soda Springs, ID 83276 | 2014-12-08 |
| 1710158886 | Mountain View Dental Clinic | Clinic/Center | 390 South 3rd West, Soda Springs, ID 83276 | 2008-03-17 |
| 1730240375 | Sharman Kay Snow | Social Worker | 160 N 1st E, Soda Springs, ID 83276-1203 | 2006-12-13 |
| 1609245612 | Craig Harden Richardson | Specialist/Technologist | 366 N 2nd E, Soda Springs, ID 83276-1218 | 2015-09-20 |
| 1417370388 | Saxton Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 269 N 3rd E, Soda Springs, ID 83276-1226 | 2014-01-29 |
| Find all providers in zip 83276 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518415058 | Niki Mix | Dietitian, Registered | 251 S 1st E, Soda Springs, ID 83276-1601 | 2016-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689272965 | Katelyn Diane John | Dietitian, Registered | 967 N Clithero Dr, Boise, ID 83703-5703 | 2020-10-09 |
| 1942816871 | Vanessa Yvonne Engle | Dietitian, Registered | 1095 S Stateline Rd, Driggs, ID 83422-4727 | 2020-09-16 |
| 1992310148 | Ellie Rock | Dietitian, Registered | 5424 N Sun Shimmer Ave, Meridian, ID 83646-5536 | 2020-09-14 |
| 1831703057 | Hydee Flishaw Tubbs Becker | Dietitian, Registered | 614 North Hayes Street, Moscow, ID 83843 | 2020-09-04 |
| 1639781743 | Anna Speegle | Dietitian, Registered | 427 Meadowview Ln, Twin Falls, ID 83301-6883 | 2020-08-19 |
| 1477179646 | Kayla Lynne Johnson | Dietitian, Registered | 570 Cobra Ct, Twin Falls, ID 83301-5694 | 2020-06-23 |
| 1245855113 | Megan Jensen | Dietitian, Registered | 6929 W Trail Dr, Boise, ID 83704-4568 | 2020-06-16 |
| 1063035004 | Chrisann M Hinson | Dietitian, Registered | 4716 W Quaker Ridge Dr, Meridian, ID 83646-5042 | 2020-05-26 |
| 1609497551 | Aaron Robert Calvano | Dietitian, Registered | 5350 N Moose Creek Ave, Meridian, ID 83646-3639 | 2020-05-01 |
| 1437779469 | Nutrition Dejunked LLC | Dietitian, Registered | 3350 W Americana Ter Ste 215, Boise, ID 83706-2545 | 2020-04-20 |
| Find all providers with the same taxonomy | ||||
| City | SODA SPRINGS |
| Zip Code | 83276 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.