Individual provider Active NPI

Shana Elizabeth Sporman, MS, RD, LDN

  • Registered Dietitian
  • Cambridge, MA
National Provider Identifier
1194025809
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
3024 Issued in MA
Practice address
22 Hilliard St
Cambridge, MA 02138-4972
Phone
(617) 834-7336
Fax
(866) 811-6396
NPI assigned
Oct 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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 3024 MA Primary

Addresses

Primary practice location

22 Hilliard St
Cambridge, MA 02138-4972

Mailing address

22 Hilliard St
Cambridge, MA 02138-4972
Phone (617) 834-7336

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

NPI Registry JSON

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

{
    "created_epoch": "1288137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288137600000",
    "number": "1194025809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 HILLIARD ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384972",
            "telephone_number": "617-834-7336",
            "fax_number": "866-811-6396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 HILLIARD ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384972",
            "telephone_number": "617-834-7336",
            "fax_number": "866-811-6396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPORMAN",
        "first_name": "SHANA",
        "middle_name": "ELIZABETH",
        "credential": "MS, RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-27",
        "last_updated": "2010-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "3024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; 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.