Active NPI
Marie Shimoniak, MS, RD, CNSD
- Registered Dietitian
- Martinez, CA
National Provider Identifier
1306058367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 851079
- Practice address
- 2283 Spring Lake Dr
Martinez, CA 94553-5452 - Phone
- (925) 726-8163
- Fax
- (925) 691-4643
- NPI assigned
- May 4, 2007
- 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 | 851079 | CA | Primary |
Addresses
Primary practice location
2283 Spring Lake Dr
Martinez, CA 94553-5452
Mailing address
2283 Spring Lake Dr
Martinez, CA 94553-5452
Phone (925) 726-8163
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 851079 | CA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306058367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2283 SPRING LAKE DR",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "945535452",
"telephone_number": "925-726-8163",
"fax_number": "925-691-4643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2283 SPRING LAKE DR",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "945535452",
"telephone_number": "925-726-8163",
"fax_number": "925-691-4643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIMONIAK",
"first_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "MS, RD, CNSD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "851079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinez, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.