Active NPI
Shana Cables, MS, RD, LD
- Registered Dietitian
- Andover, KS
National Provider Identifier
1013564020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2412
- Practice address
- 1426 E Timber Falls CT
Andover, KS 67002-7917 - Phone
- (636) 248-9128
- NPI assigned
- Aug 23, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2412 | KS | Primary |
Addresses
Primary practice location
1426 E Timber Falls CT
Andover, KS 67002-7917
Mailing address
1426 E Timber Falls CT
Andover, KS 67002-7917
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Flexible Nutrition LLC
Practice addresses (Care Compare)
240 N Rock Rd
Suite 303
Wichita, KS 67206-2246
Phone (316) 247-0018
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220708000601 | KS | Practitioner - Registered Dietitian Or Nutrition Professional | 3678953676 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2412 | KS | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wichita Primary Care LLC | Current | Accepting new patients |
Locations
2230 N Ridge Rd
Wichita, KS 67205
Phone (316) 448-8339
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566518400000",
"number": "1013564020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1426 E TIMBER FALLS CT",
"city": "ANDOVER",
"state": "KS",
"postal_code": "670027917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1426 E TIMBER FALLS CT",
"city": "ANDOVER",
"state": "KS",
"postal_code": "670027917",
"telephone_number": "636-248-9128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CABLES",
"first_name": "SHANA",
"credential": "MS, RD, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-23",
"last_updated": "2019-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KS",
"license": "2412",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Andover, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.