Active NPI
Shelby Moose, RD
- Registered Dietitian
- Prairie Du Chien, WI
National Provider Identifier
1316335995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2822
- Practice address
- 37868 US Highway 18
Prairie Du Chien, WI 53821-8416 - Phone
- (608) 357-2219
- Fax
- (608) 357-2254
- NPI assigned
- Jan 5, 2015
- 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 | 2822 | WI | Primary |
Addresses
Primary practice location
37868 US Highway 18
Prairie Du Chien, WI 53821-8416
Mailing address
37868 US Highway 18
Prairie Du Chien, WI 53821-8416
Phone (608) 357-2219
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 |
|---|---|---|---|
| 2822 | WI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574208000000",
"number": "1316335995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37868 US HIGHWAY 18",
"city": "PRAIRIE DU CHIEN",
"state": "WI",
"postal_code": "538218416",
"telephone_number": "608-357-2219",
"fax_number": "608-357-2254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "37868 US HIGHWAY 18",
"city": "PRAIRIE DU CHIEN",
"state": "WI",
"postal_code": "538218416",
"telephone_number": "608-357-2219",
"fax_number": "608-357-2254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOOSE",
"first_name": "SHELBY",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-05",
"last_updated": "2019-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "2822",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prairie Du Chien, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.