SHELBY SHANABERGER (NPI# 1649661638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649661638 |
| Entity Type | Individual |
| Full Name | SHELBY SHANABERGER |
| Credential | RD |
| Practice Address |
300 E Bannock St Boise ID 83712-6207 |
| Mailing Address |
4031 E Conklin Dr Meridian ID 83646-7636 |
| Practice Telephone | 2083421664 |
| Mailing Telephone | 5095546186 |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2015-02-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | D-832 | ID | Dietary & Nutritional Service Providers |
| Street Address |
300 E BANNOCK ST |
| City | BOISE |
| State | ID |
| Zip Code | 83712-6207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073541983 | David L Gee | Family Medicine | 300 E Bannock St, Boise, ID 83712-6207 | 2006-06-29 |
| 1841717428 | Terryn Martin | Nurse Practitioner | 300 E Bannock St, Boise, ID 83712-6207 | 2017-08-24 |
| 1104107317 | Colleen M Shackelford | Registered Nurse | 300 E Bannock St, Boise, ID 83712-6207 | 2011-08-31 |
| 1689744963 | Center for Lifetime Health LLC | Family Medicine | 300 E Bannock St, Boise, ID 83712-6207 | 2006-11-08 |
| 1033148044 | John J Eck | Family Medicine | 300 E Bannock St, Boise, ID 83712-6207 | 2006-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477016012 | Veranda At Barber Station LLC | Assisted Living Facility | 3266 E. Barber Valley Drive, Boise, ID 83712 | 2019-04-10 |
| 1891258612 | Mary Elizabeth Riedel | Occupational Therapist | 190 E Bancock St., Boise, ID 83712 | 2019-04-09 |
| 1427523968 | Q17 Health Partners LLC | Surgery | 100 East Idaho Street #317, Boise, ID 83712 | 2018-10-11 |
| 1053898247 | Travis Dale Worwood | Social Worker | South Entrance, 1075 E. Park Blvd, Boise, ID 83712 | 2018-07-20 |
| 1689166761 | Kristen Nicole Ray | Social Worker | 109 E Bannock St, Boise, ID 83712 | 2018-06-04 |
| 1740706894 | Meghan Heitstuman | Social Worker | 190 E Bannock Street, Boise, ID 83712 | 2017-08-21 |
| 1942759725 | Kay Craig | Physical Therapist | 190 Bannock, Boise, ID 83712 | 2016-09-22 |
| 1235686395 | Sharon Bjornson | Physical Therapist | 190 East Bannack, Boise, ID 83712 | 2016-09-07 |
| 1033576491 | Heather Hussey | Genetic Counselor, MS | 100 E Idaho Street, Msti Genetics, Boise, ID 83712 | 2016-01-15 |
| 1295139137 | Amie Bartholomeus | Massage Therapist | 100 East Idaho Street, St Luke's Mountain States Tumor Institute, Boise, ID 83712 | 2014-10-21 |
| Find all providers in zip 83712 | ||||
| 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 |
|---|---|---|---|---|
| 1689272965 | Katelyn Diane John | Dietitian, Registered | 967 N Clithero Dr, Boise, ID 83703-5703 | 2020-10-09 |
| 1245855113 | Megan Jensen | Dietitian, Registered | 6929 W Trail Dr, Boise, ID 83704-4568 | 2020-06-16 |
| 1437779469 | Nutrition Dejunked LLC | Dietitian, Registered | 3350 W Americana Ter Ste 215, Boise, ID 83706-2545 | 2020-04-20 |
| 1902445240 | Benjamin Von Lindern | Dietitian, Registered | 6333 N Buckley Pl, Boise, ID 83713-1204 | 2020-01-03 |
| 1215576095 | Lea Steiner | Dietitian, Registered | 500 W Fort St Stop 120, Boise, ID 83702-4501 | 2019-12-27 |
| 1508404880 | Morgan Alexis Pearson | Dietitian, Registered | 3301 W Camrose Ln, Boise, ID 83706-2712 | 2019-12-17 |
| 1720632433 | Jill Amber Leiser | Dietitian, Registered | 600 N Robbins Rd Ste 100, Boise, ID 83702-4564 | 2019-07-31 |
| 1790343127 | Carly Ruth Metcalf | Dietitian, Registered | 3562 S Tk Ave, Boise, ID 83705-5278 | 2019-05-31 |
| 1760049217 | Barbara Gordon | Dietitian, Registered | 2723 N Lakeharbor Ln, Boise, ID 83703-6240 | 2019-05-21 |
| 1538625827 | Boise Optimal Nutrition LLC | Dietitian, Registered | 6126 W State St Ste 206, Boise, ID 83703-2741 | 2019-02-12 |
| Find all providers in BOISE | ||||
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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.