Active NPI
Shelly Schwartz, RD
- Registered Dietitian
- Bend, OR
National Provider Identifier
1093989121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 802830
- Practice address
- 1501 NE Medical Center Dr
Bend, OR 97701-6051 - Phone
- (541) 408-6808
- NPI assigned
- Apr 18, 2008
- Sex
- Female
- Sole proprietor
- No
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 | 802830 | OR | Primary |
Addresses
Primary practice location
1501 NE Medical Center Dr
Bend, OR 97701-6051
Mailing address
2660 NE Hwy 20
Ste 610 PMB 201
Bend, OR 97701
Phone (541) 548-4255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 802830 | Other | OR | RD NUMBER |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 592 | OR | MD | Clinical Social Worker |
| 802830 | OR | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410307200000",
"number": "1093989121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2660 NE HWY 20",
"address_2": "STE 610 PMB 201",
"city": "BEND",
"state": "OR",
"postal_code": "97701",
"telephone_number": "541-548-4255",
"fax_number": "541-548-4255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 NE MEDICAL CENTER DR",
"city": "BEND",
"state": "OR",
"postal_code": "977016051",
"telephone_number": "541-408-6808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHWARTZ",
"first_name": "SHELLY",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-18",
"last_updated": "2014-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": "802830",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RD NUMBER",
"identifier": "802830",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.