Individual provider Active NPI

Sharon Kay Cordes, MS RD CDE LMNT

  • Registered Dietitian
  • Grand Island, NE
National Provider Identifier
1124117726
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
559 Issued in NE
Practice address
2201 N Broadwell Ave
Grand Island, NE 68803-2153
Phone
(308) 382-3660
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 559 NE Primary

Addresses

Primary practice location

2201 N Broadwell Ave
Grand Island, NE 68803-2153

Mailing address

2419 Del Monte Ave
Grand Island, NE 68803-6326
Phone (308) 384-3696

Other identifiers 1

IdentifierTypeStateIssuer
559OtherNESTATE LICENSE

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
559NEMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124117726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2419 DEL MONTE AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688036326",
            "telephone_number": "308-384-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 N BROADWELL AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688032153",
            "telephone_number": "308-382-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDES",
        "first_name": "SHARON",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "MS RD CDE LMNT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NE",
            "license": "559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "559",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.