Active NPI
Dorothy S Shaver, RD,LD/N
- Registered Dietitian
- Roanoke, VA
National Provider Identifier
1225293459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- L003065
- Practice address
- 3631 Peters Creek Rd NW
Roanoke, VA 24019-2809 - Phone
- (540) 561-3341
- Fax
- (540) 563-3630
- NPI assigned
- Jul 28, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | L003065 | NC | |
| Registered Dietitian | 133V00000X | L003065 | NC | Primary |
Addresses
Primary practice location
3631 Peters Creek Rd NW
Roanoke, VA 24019-2809
Mailing address
409 Washington Ave SW
Roanoke, VA 24016-4217
Phone (540) 815-6937
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| KY2038 | Other | KY | STATE |
| L003065 | Other | NC | STATE |
| LD6018 | Other | OH | STATE |
| 677 | Other | WV | STATE |
| LDN0000001893 | Other | TN | STATE |
| 926124 | Other | DIETITIAN REGISTRATION - NATIONAL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L003065 | NC | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217203200000",
"number": "1225293459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 WASHINGTON AVE SW",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240164217",
"telephone_number": "540-815-6937",
"fax_number": "540-563-3630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3631 PETERS CREEK RD NW",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240192809",
"telephone_number": "540-561-3341",
"fax_number": "540-563-3630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAVER",
"first_name": "DOROTHY",
"middle_name": "S",
"credential": "RD,LD/N",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-28",
"last_updated": "2008-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "NC",
"license": "L003065",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L003065",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE",
"identifier": "KY2038",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE",
"identifier": "L003065",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE",
"identifier": "LD6018",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE",
"identifier": "677",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE",
"identifier": "LDN0000001893",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DIETITIAN REGISTRATION - NATIONAL",
"identifier": "926124",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.