AMY MODRACEK (NPI# 1033246574) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033246574 |
| Entity Type | Individual |
| Full Name | AMY MODRACEK |
| Credential | RD |
| Practice Address |
134 Thurbers Ave Family Service of Rhode Island Providence RI 02905-4754 |
| Mailing Address |
1440 Phillips Rd New Bedford MA 02745-1958 |
| Practice Telephone | 4013311350 |
| Practice Fax Number | 4012773366 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | LDN00543 | RI | Dietary & Nutritional Service Providers |
| N | 133V00000X | Dietitian, Registered | RD657 | MA | Dietary & Nutritional Service Providers |
| Street Address |
134 THURBERS AVE FAMILY SERVICE OF RHODE ISLAND |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02905-4754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073546297 | Rebecca Lynne Collins | Occupational Therapist | 134 Thurbers Ave, C/o Family Service of Ri, Providence, RI 02905-4754 | 2006-07-09 |
| 1609474261 | Alyssa Loberti | Speech-Language Pathologist | 134 Thurbers Ave, Providence, RI 02905-4754 | 2020-10-15 |
| 1093313819 | Victoria Leeann Dekoatz | Speech-Language Pathologist | 134 Thurbers Ave, Providence, RI 02905-4754 | 2020-10-14 |
| 1780228825 | Shannon Cain Lynch | Social Worker | 134 Thurbers Ave, Providence, RI 02905-4754 | 2019-11-01 |
| 1649827890 | Jessie Ortiz | Social Worker | 134 Thurbers Ave, Providence, RI 02905-4754 | 2019-08-22 |
| 1689232456 | Mary C Craven | Counselor | 134 Thurbers Ave, Providence, RI 02905-4754 | 2019-06-05 |
| 1689035701 | Nahdee Bedee Goe | Social Worker | 134 Thurbers Ave, Suit 102, Providence, RI 02905-4754 | 2016-03-17 |
| 1093111247 | Robert Robillard Jr. | Counselor | 134 Thurbers Ave, Providence, RI 02905-4754 | 2014-11-17 |
| 1982008231 | John Reardon | Social Worker | 134 Thurbers Ave, Providence, RI 02905-4754 | 2014-10-15 |
| 1932508082 | Kathryn Cormier | Specialist | 134 Thurbers Ave, Suite 220a, Providence, RI 02905-4754 | 2014-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477100808 | Raisa Emilia Garcia-diaz | Counselor | 66 Pavilion Avenue, Providence, RI 02905 | 2019-08-21 |
| 1962976571 | Nike A. Kendall | Social Worker | Program In Women's Oncology, 101 Dudley Street, Providence, RI 02905 | 2019-01-16 |
| 1891265443 | Carolyn Te Young | Pathology | 1320 Narragansett Blvd, Cranston, RI 02905 | 2018-11-27 |
| 1417427071 | Julianne Elizabeth Houtchens | Dietitian, Registered | Adult Primary Care 245 Chapman Street, Providence, RI 02905 | 2018-11-27 |
| 1922577394 | Dilenia C Cruz | Health Educator | 335r Prairie Ave., Suite 2b, Providence, RI 02905 | 2018-11-15 |
| 1639653116 | Varina S. Gunn | Health Educator | 335r Prarie Ave., Suite 2b, Providence, RI 02905 | 2018-09-20 |
| 1427590421 | Cardea Healthcare LLC | In Home Supportive Care | 100 Pavilion Avenue, Suite 101, Providence, RI 02905 | 2016-11-08 |
| 1265884597 | Maxwell King | Physical Therapy Assistant | 48 Moorland Avenue, Cranston, RI 02905 | 2016-07-11 |
| 1346698024 | Samantha Lea Colli | Physician Assistant | 100 Dudley St Fl 3, Providence, RI 02905 | 2016-06-02 |
| 1346697448 | Amy Jean Simpson | Marriage & Family Therapist | 1981 Broad Street, Cranston, RI 02905 | 2016-05-18 |
| Find all providers in zip 02905 | ||||
| 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 |
|---|---|---|---|---|
| 1104452747 | Lynn Ellen Przystac | Dietitian, Registered | 101 Dudley St Dept Of, Providence, RI 02905-2499 | 2020-03-16 |
| 1417427071 | Julianne Elizabeth Houtchens | Dietitian, Registered | Adult Primary Care 245 Chapman Street, Providence, RI 02905 | 2018-11-27 |
| 1023562501 | Julia E. Berman | Dietitian, Registered | 114 11th St, Providence, RI 02906-2912 | 2016-08-12 |
| 1871989137 | Shira Hirshberg | Dietitian, Registered | 271a S Main St, Providence, RI 02903-2910 | 2015-04-13 |
| 1336553643 | Seven Peas, LLC | Dietitian, Registered | 219 W Park St, Providence, RI 02908-4851 | 2014-06-13 |
| 1598195497 | Shira Hirshberg | Dietitian, Registered | 383 W Fountain St Ste 105, Providence, RI 02903-3515 | 2013-11-14 |
| 1245582477 | Healthy Ever After LLC | Dietitian, Registered | 438 Broadway, Providence, RI 02909-1622 | 2012-10-11 |
| 1033419858 | Randi Konikoff Beranbaum | Dietitian, Registered | 5 Wingate Rd, Providence, RI 02906-4909 | 2010-10-26 |
| 1619201985 | Diana Rose Beaton | Dietitian, Registered | 325 Angell St, Providence, RI 02906 | 2009-09-19 |
| 1154654788 | Elizabeth F Fayram | Dietitian, Registered | 1 Richmond Sq Ste 158e, Providence, RI 02906-5141 | 2009-09-15 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02905 |
Please comment or provide details below to improve the information on AMY MODRACEK.
| 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.