Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1578900684 Individual Practitioner Female Practitioner

Amanda Boostrom , RDN

Dietitian, Registered • Annandale, VA

Professional Overview & Biography Verified Profile Summary

Amanda Boostrom, RDN is a registered healthcare professional specializing in Dietitian, Registered in Annandale, VA. Practice services are available at 4513 WILLET DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4513 Willet Dr

Annandale, VA 220033944

Telephone 7038312125
Associated Practice Facility / Clinic
🏢 The Sweet Life Nutrition Llc Facility NPI 1790203677

Specialty Benchmarks & Practice Insights

Comparative analytics for Dietitian, Registered in Annandale, VA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
5 Specialists

Practicing in Annandale, VA (1320 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dietitian, Registered Primary Specialty

NUCC Taxonomy Code: 133V00000X

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Secondary Practice Locations

502 W Lake St, Gifford Building #114

Fort Collins, CO 805230001

Phone: 9704918615

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

15 Historical Events
NPI Profile Active August 31, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location August 31, 2017

Registered at 4513 WILLET DR, ANNANDALE, VA 220033944 (Tel: (703) 831-2125)

📍
Updated Business Mailing Address August 31, 2017

Registered at 4513 WILLET DR, ANNANDALE, VA 220033944 (Tel: (703) 831-2125)

👤
Provider Name / Credentials Updated August 31, 2017

Recorded as AMANDA BOOSTROM, RDN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 31, 2017

Dietitian, Registered

📍
Updated Practice Location February 16, 2017

Registered at 502 W LAKE ST, GIFFORD BUILDING #114, FORT COLLINS, CO 805230001 (Tel: 9704918615)

📍
Updated Business Mailing Address February 16, 2017

Registered at 502 W LAKE ST, GIFFORD BUILDING #114, FORT COLLINS, CO 805230001 (Tel: 9704918615)

👤
Provider Name / Credentials Updated February 16, 2017

Recorded as AMANDA BOOSTROM, RDN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 16, 2017

Dietitian, Registered

NPI Profile Active May 30, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location May 30, 2013

Registered at 108 PARK PL, CAMP HILL, PA 170117222 (Tel: 8002038657)

📍
Updated Business Mailing Address May 30, 2013

Registered at 108 PARK PL, CAMP HILL, PA 170117222 (Tel: 8002038657)

👤
Provider Name / Credentials Updated May 30, 2013

Recorded as AMANDA RUSSELL

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 30, 2013

Dietitian, Registered (License #DN005089 in PA)

🟢
Initial NPI Registration & Enumeration May 30, 2013

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1578900684
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 30, 2013
Last Update: July 21, 2022
Sole Proprietor: No

Mailing Address

4513 Willet Dr

Annandale, VA 220033944

Phone: 7038312125

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.