AMY N ROARK (L..D.) – Registered Dietitian, NPI 1699771311

AMY N ROARK (L..D.) is a healthcare provider. based in Gainesville, Georgia. specializing in REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL. They hold the professional credentials L..D.. The NPI Number for AMY N ROARK (L..D.) is 1699771311

Main info

Female
29 Years Of Experience
Accepts Medicare Assignment
Name
AMY N ROARK (L..D.)
NPI
1699771311
Phone
(770) 536-9864
Address
1240 JESSE JEWELL PKWY SE
Enumeration Date
27 June 2005
Last Update Date
2 August 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7705369864
Graduation Year
1997 (29 years ago)
PAC ID
8022132935
Group Practice PAC ID
1951655737
Professional Enrollment ID
I20100830000670
Address ID
GA305013861GA1240XSEXX505
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:20State licenses:0Digital endpointsOther names

115 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in GA

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Provider Addresses for AMY N ROARK (L..D.)

  • Jesse Jewell Parkway Southeast, Gainesville, Hall County, Georgia, 30501, United States

    SUITE 500

    GAINESVILLE, GA 305013862

    Phone: (770) 536-9864

    Fax: (770) 297-5023

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-08-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100830000670IRegistered Dietitian Or Nutrition ProfessionalGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97803Therapy procedure reassessment for nutrition management, each 15 minutes16943$0
97802Therapy procedure for nutrition management, each 15 minutes10927$0
View full utilization report →

Insurance plans in this area (ZIP 30501)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1951655737View full group profile
NameSpecialtyState
Pulmonary Disease, Critical Care (Intensivists)GA
Pulmonary DiseaseGA
Nurse PractitionerGA
Pulmonary DiseaseGA
Internal MedicineGA
Internal MedicineGA
Internal MedicineGA
-GA
Nephrology, Internal MedicineGA
E N D O C R I N O L O G YMS

Reviews

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Frequently asked questions

What is AMY N ROARK (L..D.)'s NPI number?
AMY N ROARK (L..D.)'s NPI is 1699771311 — the number used across U.S. healthcare to identify this provider.
Is AMY N ROARK (L..D.) still an active registrant?
AMY N ROARK (L..D.) carries an active NPI according to the public dataset.
How would a patient describe AMY N ROARK (L..D.)'s focus?
For AMY N ROARK (L..D.), the primary taxonomy reads as Registered Dietitian. Clinical services aligned with this taxonomy classification.
Where in Georgia is AMY N ROARK (L..D.) registered?
Use Gainesville, Georgia as the headline location for AMY N ROARK (L..D.) here.
When was this NPI issued?
Enumeration for AMY N ROARK (L..D.) is noted as June 27, 2005 where the registry provides it.

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