Active NPI
Shelley A Gaggini, DIETITIAN
- Registered Dietitian
- Tupelo, MS
National Provider Identifier
1437317583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 710891
- Practice address
- 4250 S Eason Blvd
Tupelo, MS 38801-6549 - Phone
- (662) 377-6275
- Fax
- (662) 377-6299
- NPI assigned
- May 27, 2008
- Sex
- Female
- Sole proprietor
- No
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 | 710891 | MS | Primary |
Addresses
Primary practice location
4250 S Eason Blvd
Tupelo, MS 38801-6549
Mailing address
4250 S Eason Blvd
Tupelo, MS 38801-6549
Phone (662) 377-6275
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C03449 | Other | MS | MEDICARE GROUP |
Other names 1
- Shelley Jones
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 |
|---|---|---|---|
| 710891 | MS | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amory Surgery Clinic, PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485993600000",
"number": "1437317583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4250 S EASON BLVD",
"city": "TUPELO",
"state": "MS",
"postal_code": "388016549",
"telephone_number": "662-377-6275",
"fax_number": "662-377-6299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4250 S EASON BLVD",
"city": "TUPELO",
"state": "MS",
"postal_code": "388016549",
"telephone_number": "662-377-6275",
"fax_number": "662-377-6299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAGGINI",
"first_name": "SHELLEY",
"middle_name": "A",
"credential": "DIETITIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-27",
"last_updated": "2017-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MS",
"license": "710891",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "C03449",
"state": "MS"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SHELLEY",
"last_name": "JONES",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Tupelo, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.