Gwen Catherine Shipley, RD LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2007028040 Issued in MO

Practice address

2620 N Westwood Blvd
Poplar Bluff, MO 63901-3396

Phone

(573) 686-5993

NPI assigned

Aug 31, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251676800000",
    "number": "1386877926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013396",
            "telephone_number": "573-686-5993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013396",
            "telephone_number": "573-686-5993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPLEY",
        "first_name": "GWEN",
        "middle_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "RD LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2009-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2007028040",
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "MO",
            "license": "2007028040",
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "MO",
            "license": "2007028040",
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "MO",
            "license": "2007028040",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Shelton
• Breanne Gail Shepherd
• Sierra Kay Shepherd
• Sarah Sheppard
• Wanda R Shewmon, N.P.
• Amy Elizabeth Shirrell
• Marsha D Shivley, FNP
• Chelsea Shockley
• Jason Jerome Shupe
• Eduard Shvartsberg, DDS

• Registered Dietitian in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Registered Dietitian in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; 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.