Active NPI
Victoria Shoemaker, LDN, RDN
- Registered Dietitian
- Peebles, OH
National Provider Identifier
1295375103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD.09025
- Practice address
- 629 Black Hollow Rd
Peebles, OH 45660-9293 - Phone
- (817) 791-8784
- Fax
- (937) 507-3702
- NPI assigned
- Jan 8, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | LD.09025 | OH | Primary |
Addresses
Primary practice location
629 Black Hollow Rd
Peebles, OH 45660-9293
Mailing address
629 Black Hollow Rd
Peebles, OH 45660-9293
Phone (817) 791-8784
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 |
|---|---|---|---|
| LD.09025 | OH | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609372800000",
"number": "1295375103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "629 BLACK HOLLOW RD",
"city": "PEEBLES",
"state": "OH",
"postal_code": "456609293",
"telephone_number": "817-791-8784",
"fax_number": "937-507-3702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "629 BLACK HOLLOW RD",
"city": "PEEBLES",
"state": "OH",
"postal_code": "456609293",
"telephone_number": "817-791-8784",
"fax_number": "937-507-3702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOEMAKER",
"first_name": "VICTORIA",
"credential": "LDN, RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-08",
"last_updated": "2020-12-31",
"certification_date": "2020-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "LD.09025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peebles, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.