Shaily Ravae Harris

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

38326DI-0 Issued in NV

Practice address

5761 S Fort Apache Rd
Las Vegas, NV 89148-5506

Phone

(702) 341-6610

Fax

(702) 341-6961

NPI assigned

Apr 12, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shaily Ravae Gentile Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1194222430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5761 S FORT APACHE RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485506",
            "telephone_number": "702-341-6610",
            "fax_number": "702-341-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5761 S FORT APACHE RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485506",
            "telephone_number": "702-341-6610",
            "fax_number": "702-341-6961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "SHAILY",
        "middle_name": "RAVAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NV",
            "license": "38326DI-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAILY",
            "last_name": "GENTILE",
            "middle_name": "RAVAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Roshonda Ann Harris
• Ruby Alana Harris
• Sabre D Harris
• Sabrina Harris
• Sayonara Harris
• Shalonda Michelle Harris
• Shannon Harris, LPN
• Shannon Danielle Harris
• Sharon Ilene Harris, MS, MFT, LADC
• Sharon Marie Harris

• Registered Dietitian in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Registered Dietitian in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.