Individual provider Active NPI

Sonya Shamalov, MS, RDN

  • Registered Dietitian
  • Flushing, NY
National Provider Identifier
1043804479
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86156817 Issued in NY
Practice address
14127 78TH Rd Apt 2D
Flushing, NY 11367-3344
Phone
(347) 320-4835
NPI assigned
Feb 25, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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 86156817 NY Primary

Addresses

Primary practice location

14127 78TH Rd Apt 2D
Flushing, NY 11367-3344

Mailing address

14127 78TH Rd Apt 2D
Flushing, NY 11367-3344
Phone (347) 320-4835

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
86156817NYMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1043804479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14127 78TH RD APT 2D",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673344",
            "telephone_number": "347-320-4835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14127 78TH RD APT 2D",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673344",
            "telephone_number": "347-320-4835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMALOV",
        "first_name": "SONYA",
        "credential": "MS, RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-25",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "86156817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.