Individual provider Active NPI

Shana Cables, MS, RD, LD

  • Registered Dietitian
  • Andover, KS
National Provider Identifier
1013564020
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2412 Issued in KS
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

Updated by the provider on Aug 23, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 4 clinicians

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 IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
2412KSMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Wichita Primary Care LLC CurrentSince Jul 11, 2022 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.

Verify at the official NPI Registry.