AMY PUCKETT (NPI# 1962829317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962829317 |
| Entity Type | Individual |
| Full Name | AMY PUCKETT |
| Credential | RD |
| Practice Address |
13090 N 94th Dr Ste 210 Peoria AZ 85381 |
| Mailing Address |
25614 N 92nd Ave Peoria AZ 85383-1274 |
| Practice Telephone | 6239741763 |
| Practice Fax Number | 6239722038 |
| Mailing Telephone | 4807172100 |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2019-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 86009206 | AZ | Dietary & Nutritional Service Providers |
| Street Address |
13090 N 94TH DR STE 210 |
| City | PEORIA |
| State | AZ |
| Zip Code | 85381 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114064995 | Northwest Valley Health Associates | Internal Medicine | 13090 N 94th Dr Ste 210, Peoria, AZ 85381-4258 | 2007-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932712122 | Vicki L Grenier | Registered Nurse | 7558 W. Thunderbird Rd. Ste 1-507, Peoria, AZ 85381 | 2020-08-26 |
| 1568934107 | Earthwalk Wellness Group, LLC | Social Worker | 14050 North 83rd Avenue, Suite 290, Peoria, AZ 85381 | 2018-12-20 |
| 1316412059 | John & Biljana Feeley Dba J & B Assisted Living IIi Inc | Community Based Residential Treatment Facility, Mental Illness | 7331 W Sweetwater Avenue, Peoria, AZ 85381 | 2018-10-09 |
| 1467958611 | Arizona Community Pharmacy | Pharmacy | 14100 N 83rd Ave Ste 160, Peoria, AZ 85381 | 2018-04-04 |
| 1083112106 | Marissa Lynn Desjardins | Physical Therapist | 8240 W. Cactus Rd. Oakeson Physical Therapy, Peoria, AZ 85381 | 2018-01-23 |
| 1235651399 | Power Back Batteries LLC | Durable Medical Equipment & Medical Supplies | 9054 West Lisbon Ave, Peoria, AZ 85381 | 2017-07-11 |
| 1457897027 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 7524 W. Alexandria Way, Peoria, AZ 85381 | 2017-01-06 |
| 1386023448 | Scott Boone | Registered Nurse | 7715 W Watson Ln, Peoria, AZ 85381 | 2015-05-22 |
| 1881084838 | Pinnacle Women's Center LLC | Obstetrics & Gynecology | 15396 N 83rd Ave Ste F100, Peoria, AZ 85381 | 2015-01-29 |
| 1245637081 | Kathi Locke | Counselor | 13460 N. 94th Drive, Suite J2, Peoria, AZ 85381 | 2014-11-21 |
| Find all providers in zip 85381 | ||||
| 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 |
|---|---|---|---|---|
| 1255950366 | Colleen Hamilton | Dietitian, Registered | 1109 W Sleepy Hollow Ct, Peoria, IL 61615-1101 | 2020-04-09 |
| 1518328665 | Jenna Bishop | Dietitian, Registered | 600 Ne Water Street, Peoria, IL 61637 | 2016-03-17 |
| 1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
| 1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
| 1437536984 | Ashley Thomas | Dietitian, Registered | 1609 W Moss Ave, Peoria, IL 61606-1642 | 2015-05-05 |
| 1205228558 | Ana Cristina Schallhorn | Dietitian, Registered | 4813 N Glen Ct, Peoria, IL 61614-4644 | 2015-02-24 |
| 1164844262 | Kelsey Knott | Dietitian, Registered | 4125 N Sheridan Rd Ste 20, Peoria, IL 61614-7174 | 2014-01-09 |
| 1285078931 | Marilyn Bukoff Priddy | Dietitian, Registered | 1617 W Devereux Dr, Peoria, IL 61614-4009 | 2013-04-24 |
| 1992061998 | Mayuri Rangdal | Dietitian, Registered | 2640 W Stonehenge Ct, Peoria, IL 61615-7477 | 2012-04-04 |
| 1851692123 | Lauren Ashley Rusk | Dietitian, Registered | 9900 N Dalea Ln, 9212, Peoria, IL 61615-7268 | 2010-11-03 |
| Find all providers in PEORIA | ||||
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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.