Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amy N Roark, LD

Individual provider Registered Dietitian · NPI 1699771311

Amy N Roark, LD is a Registered Dietitian OR Nutrition Professional in Gainesville, Georgia. Qualified in 1997, 29 years ago. Practices with Northeast Georgia Diagnostic Associates and Clinic, LLC, a 81-clinician group and accepts Medicare assignment.

Years since qualifying
29
In the registry since
2005
What do these letters mean?
LD — Licensed Dietitian
A dietitian licensed by a state board.

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Practice location Address checks out

1240 Jesse Jewell Pkwy SE Ste 500
Gainesville, GA 30501-3862
Phone: (770) 536-9864
Fax: (770) 297-5023
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X

Record details

NPI number1699771311
Entity typeIndividual (Type 1)
GenderFemale
Credentials LD
Sole proprietorNo
NPI enumeratedJune 27, 2005
Last updated in NPPESAugust 2, 2010
Mailing address1240 Jesse Jewell Pkwy Se, Suite 500, Gainesville, GA 30501-3862

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Northeast Georgia Diagnostic Associates And Clinic, Llc — 81 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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