Kathy Jo Shattler, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

00710393 Issued in MI

Practice address

5550 Mall Dr W
# 1108
Lansing, MI 48917-3252

Phone

(517) 574-4767

NPI assigned

Dec 1, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science, Master of Science

State licenses

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

{
    "created_epoch": "1417392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736035200000",
    "number": "1306243753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5550 MALL DR W",
            "address_2": "# 1108",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489173252",
            "telephone_number": "517-348-4572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 MALL DR W",
            "address_2": "# 1108",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489173252",
            "telephone_number": "517-574-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHATTLER",
        "first_name": "KATHY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-01",
        "last_updated": "2025-01-05",
        "certification_date": "2025-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "00710393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDR CREDENTIALLING NUMBER",
            "identifier": "00710393",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aparna Sharma, MD
• Richard Sharon, DO
• Mary P Sharp, M.D.
• Krystel Samantha Sharpe-Kamer, D.O.
• Megan Sharrow
• Brandy Lynne Shattuck, M. D.
• Mackenzie Leigh Shattuck, DO
• Farheen Shaukat, MD
• Karlee Shave, LMSW
• Darcy Donovan Shaw, M.D.

• Registered Dietitian in Lansing, MI
• Providers in Lansing, MI by specialty
• Registered Dietitian in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2025; 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.