Active NPI
Shelley Porter, LRD
- Registered Dietitian
- Bismarck, ND
National Provider Identifier
1235273855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 28
- Practice address
- 900 E Broadway Avenue
Bismarck, ND 58501 - Phone
- (701) 530-7000
- Fax
- (701) 530-8842
- NPI assigned
- Feb 16, 2007
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 28 | ND | Primary |
Addresses
Primary practice location
900 E Broadway Avenue
Bismarck, ND 58501
Mailing address
900 E Broadway Avenue
P.O. Box 997
Bismarck, ND 58502-0997
Phone (701) 530-7000
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28 | ND | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280534400000",
"number": "1235273855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 E BROADWAY AVENUE",
"address_2": "P.O. BOX 997",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585020997",
"telephone_number": "701-530-7000",
"fax_number": "701-530-8842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 E BROADWAY AVENUE",
"city": "BISMARCK",
"state": "ND",
"postal_code": "58501",
"telephone_number": "701-530-7000",
"fax_number": "701-530-8842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "SHELLEY",
"credential": "LRD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-16",
"last_updated": "2010-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ND",
"license": "28",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bismarck, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.