Andrea Dawn Shotton, MS RD LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1659 Issued in OK

Practice address

21333 E 104TH St
Broken Arrow, OK 74014-3669

Phone

(918) 449-1123

NPI assigned

Jun 16, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Morton Comprehensive Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Tulsa, OK
  • NPI 1275528085
  Medicare reassignment NPD
• Morton Comprehensive Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Tulsa, OK
  • NPI 1457166522
  NPD
• Morton Comprehensive Health Services, Inc

  dba East Tulsa Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Tulsa, OK
  • NPI 1205822830
  NPD (past)
• University of Tennessee

  dba Center on Developmental Disabilities

  • Developmental Disabilities Clinic/Center
  • Memphis, TN
  • NPI 1427064880
  NPD (past)

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297468800000",
    "number": "1184851255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21333 E 104TH ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740143669",
            "telephone_number": "918-449-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21333 E 104TH ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740143669",
            "telephone_number": "918-449-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOTTON",
        "first_name": "ANDREA",
        "middle_name": "DAWN",
        "credential": "MS RD LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2011-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "TN",
            "license": "1371",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "1659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05376085",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200255350 B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica D. Shinn, PHARM.D.
• Tracy L Shoemaker, OD
• Shoop Family Dentistry, LLC
• Elizabeth Ann Short, MCD, CCC SLP
• Jennifer Lea Short, COTA
• Stephen C Shuey, D.C.
• Maria L Shultz
• Sarah Shwayyat
• Robert Austin Sibley, DO
• Sarah Sifran-McClellan, MS LPC

• Registered Dietitian in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Registered Dietitian in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.