Active NPI
Shauna C Phipps, R.D.
- Registered Dietitian
- Joint Base Lewis McChord, WA
National Provider Identifier
1356636864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DI 60165206
- Practice address
- 9040 Jackson Ave
Joint Base Lewis McChord, WA 98431-1100 - Phone
- (253) 968-0573
- NPI assigned
- Jun 13, 2011
- 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 | DI 60165206 | WA | Primary |
Addresses
Primary practice location
9040 Jackson Ave
Joint Base Lewis McChord, WA 98431-1100
Mailing address
9040 Reid St
Attn:MCHJ-QCR
Joint Base Lewis McChord, WA 98431-1100
Phone (253) 968-2252
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI 60165206 | WA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558569600000",
"number": "1356636864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9040 REID ST",
"address_2": "ATTN:MCHJ-QCR",
"city": "JOINT BASE LEWIS MCCHORD",
"state": "WA",
"postal_code": "984311100",
"telephone_number": "253-968-2252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9040 JACKSON AVE",
"city": "JOINT BASE LEWIS MCCHORD",
"state": "WA",
"postal_code": "984311100",
"telephone_number": "253-968-0573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHIPPS",
"first_name": "SHAUNA",
"middle_name": "C",
"credential": "R.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-13",
"last_updated": "2019-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "DI 60165206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joint Base Lewis McChord, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.