Stephanie Shryock

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

101908 Issued in AK

Practice address

3449 Rezanof Dr E
Kodiak, AK 99615-6952

Phone

(907) 486-9800

NPI assigned

Aug 5, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kodiak Area Native AssociationGroup PAC ID 8426959297, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Kodiak Area Native Association

  • Community Health Clinic/Center
  • Kodiak, AK
  • NPI 1679514236

  TX

  Medicare reassignment Care Compare group
• Kodiak Area Native Association

  • Dental Clinic/Center
  • Kodiak, AK
  • NPI 1205883907
  NPD (past)

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1437535010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3449 REZANOF DR E",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3449 REZANOF DR E",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156952",
            "telephone_number": "907-486-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRYOCK",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-05",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AK",
            "license": "101908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodney William Seifert, HEALTH SERVICES TECH
• Senior Citizens of Kodiak, Inc.
• Jason Alexander Sessoms
• John Shank, OD
• Starr Shanley
• Lori Ann Siebe, LMT
• Tania V Silva
• Melissa M Smith, DVM
• Steve Smith, HYGIENIST
• Steven W Smith, MD

• Registered Dietitian in Kodiak, AK
• Providers in Kodiak, AK by specialty
• Registered Dietitian in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.