Nami Shin, DCN, LDN, CNS

Primary specialty

NutritionistTaxonomy code 133N00000X

License

011215-01 Issued in NY

Practice address

4232 Albany Post Rd
Hyde Park, NY 12538-1766

Phone

(845) 594-3697

NPI assigned

Jan 31, 2023

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Specialist

State licenses

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1437865656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 ROUTE 9W # 309",
            "city": "WEST PARK",
            "state": "NY",
            "postal_code": "124939800",
            "telephone_number": "845-594-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4232 ALBANY POST RD",
            "city": "HYDE PARK",
            "state": "NY",
            "postal_code": "125381766",
            "telephone_number": "845-594-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "NAMI",
        "name_prefix": "Dr.",
        "credential": "DCN, LDN, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NY",
            "license": "011215-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS BOARD OF EDUCATION OFFICE OF PROFESSIONS",
            "identifier": "011215-01",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sean L. Martin, D.C.,P.C.
• Melissa June Secor, RPH
• Cynthia Lynn Shellhammer, LPN
• Emily Sheridan
• Marla Ann Sherman, LCSW
• Lauren Silverman
• Lakeram Singh
• William Charles Skojec, PSYD
• SLN Transportation
• Megan Smith, LMSW

• Nutritionist in Hyde Park, NY
• Providers in Hyde Park, NY by specialty
• Nutritionist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.