Active NPI
Shala Davidson
- Nutrition Education Nutritionist
- Shenandoah, IA
National Provider Identifier
1154797876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Education Nutritionist
- Practice address
- 300 Pershing Ave
Shenandoah, IA 51601-2355 - Phone
- (712) 246-1230
- Fax
- (712) 246-7357
- NPI assigned
- Aug 17, 2015
- Last updated
- Aug 17, 2015
- 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 |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | NU | Primary |
Addresses
Primary practice location
300 Pershing Ave
Shenandoah, IA 51601-2355
Mailing address
300 Pershing Ave
Shenandoah, IA 51601-2355
Phone (712) 246-1230
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439769600000",
"number": "1154797876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 PERSHING AVE",
"city": "SHENANDOAH",
"state": "IA",
"postal_code": "516012355",
"telephone_number": "712-246-1230",
"fax_number": "712-246-7357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PERSHING AVE",
"city": "SHENANDOAH",
"state": "IA",
"postal_code": "516012355",
"telephone_number": "712-246-1230",
"fax_number": "712-246-7357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "SHALA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-17",
"last_updated": "2015-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shenandoah, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.