Shannon Busby Bagga, RDN, LD

Individual provider Active NPI Registered Dietitian · Atlanta, GA

NPI 1033716774 · NPPES record last updated Oct 6, 2020

Key facts

NPI
1033716774
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
LD004548 (GA)
Practice address
1806 Dekalb Ave NE
Atlanta, GA 30307
Phone
(404) 483-8946
NPI assigned
Oct 6, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LD004548GAMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD004548 GA Yes

Addresses

Primary practice location

1806 Dekalb Ave NE
Atlanta, GA 30307

Mailing address

1806 Dekalb Ave NE
Atlanta, GA 30307
Phone (404) 483-8946

Other names

  • Shannon Leigh Busby Former name

Other providers in Atlanta, GA

All providers in Atlanta, GA · Registered Dietitian in Georgia

Sources for this page

Verify at the official NPI Registry.