MS. AMBER LAKE (NPI# 1588214241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588214241 |
| Entity Type | Individual |
| Full Name | MS. AMBER LAKE |
| Credential | MS, RD |
| Practice Address |
508 Fulton St Durham NC 27705-3875 |
| Practice Telephone | 9192860411 |
| Enumeration Date | 2019-09-16 |
| Last Update Date | 2019-09-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | L005876 | NC | Dietary & Nutritional Service Providers |
| Street Address |
508 FULTON ST |
| City | DURHAM |
| State | NC |
| Zip Code | 27705-3875 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043217086 | Stuart Hall Manning | Internal Medicine | 508 Fulton St, C/o Durham Va Medical Center, Durham, NC 27705-3875 | 2005-07-06 |
| 1245839083 | Jessica Elizabeth Cornett | Recreation Therapist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-22 |
| 1043819808 | Rebecca Parker Maccioli | Recreation Therapist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-22 |
| 1174122055 | Aline Xayasouk | Occupational Therapist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-21 |
| 1730786187 | Kathryn Masincupp | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-07 |
| 1700490349 | Sarah Elizabeth Parker | Nurse Practitioner | 508 Fulton St, Durham, NC 27705-3875 | 2020-09-01 |
| 1144833716 | Phillip Charles Tampis | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-24 |
| 1164033445 | Alexandra Demascole | Social Worker | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-11 |
| 1386254498 | Krishna Rana | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-04 |
| 1730799842 | Jinah Han | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371755 | Tyler Beach, Lcsw, Pllc | Social Worker | 2740 Spencer Street, Durham, NC 27705 | 2019-11-20 |
| 1720635477 | Brittany W Fry | Registered Nurse | 2301 Erwin Road, Hafs Building, Room 6670, Durham, NC 27705 | 2019-08-19 |
| 1760968044 | Nicole D Moore | Social Worker | 1921 N. Pointe Dr, Suite 280, Durham, NC 27705 | 2018-07-19 |
| 1144757097 | Emileigh S Dowling | Physical Therapist | 3475 Erwin Rd Bldg 2, Durham, NC 27705 | 2017-05-22 |
| 1487195350 | Daniel Lynch | Physical Therapist | 3475 Erwin Road, Pepsico Building, Durham, NC 27705 | 2017-03-13 |
| 1780131839 | Michael A Fitzpatrick Iv | Physical Therapist | 3475 Erwin Rd Bldg 2nd, Durham, NC 27705 | 2016-09-07 |
| 1609241736 | Julia Power Constant | Physician Assistant | Dumc Box 3913, Durham, NC 27705 | 2015-12-01 |
| 1518344159 | Amanda Clark Coniglio | Internal Medicine | 2301 Erwin Rd # 3845, Durham, NC 27705 | 2015-05-04 |
| 1720486988 | Jennifer Dawn Pace | Physician Assistant | 1821 Hillandale Road Suite 24a, Duke Urgent Care, Durham, NC 27705 | 2014-12-19 |
| 1942612106 | Rachel Hibberd | Psychologist | 508 Fulton Avenue, Durham Va Medical Center, Durham, NC 27705 | 2014-05-22 |
| Find all providers in zip 27705 | ||||
| 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 |
|---|---|---|---|---|
| 1699382010 | Catherine Suzanne Rudolph | Dietitian, Registered | 845 Ivy Meadow Ln Apt 3b, Durham, NC 27707-5905 | 2020-09-29 |
| 1477171601 | Julie Stoops | Dietitian, Registered | 40 Duke Medicine Cir Bsmt Level015, Durham, NC 27710-4000 | 2020-07-14 |
| 1437775756 | Ann Margaret Shelton | Dietitian, Registered | 40 Medicine Circle Drive 2j Clinic, Durham, NC 27710-0001 | 2020-06-23 |
| 1467077826 | Ella Lundquist | Dietitian, Registered | Dumc 3655, Durham, NC 27710-0001 | 2020-06-11 |
| 1528683174 | Laura Elizabeth Niederer | Dietitian, Registered | 40 Duke Medicine Cir # 2j, Durham, NC 27710-4000 | 2020-06-10 |
| 1144845967 | Charlotte Walker | Dietitian, Registered | 35 Cedar Point Rd, Durham, NH 03824-3306 | 2020-06-09 |
| 1851927917 | Asta Feng | Dietitian, Registered | 130 Lochridge Dr, Durham, NC 27713-9139 | 2020-03-20 |
| 1649819707 | Cherie Nichol Barnes | Dietitian, Registered | 3508 Golden Heather Dr, Durham, NC 27712-3148 | 2020-01-06 |
| 1265081400 | Logan Pace | Dietitian, Registered | 1415 Broad St, Durham, NC 27705-3534 | 2019-09-10 |
| 1780239400 | Elizabeth Barnes | Dietitian, Registered | 6015 Fayetteville Rd Ste 116, Durham, NC 27713-6254 | 2019-08-08 |
| Find all providers in DURHAM | ||||
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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.