Shalese McMillan Pugh, RD,LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD002976 Issued in GA

Practice address

4772 Frontage Rd
Forest Park, GA 30297-1606

Phone

(919) 491-9028

NPI assigned

Sep 16, 2005

Last updated

Apr 23, 2024By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Temple Nutrition LLC

  • Registered Dietitian
  • Forest Park, GA
  • NPI 1578318390
  Authorized official Same address or phone
• Coweta County Board of Health

  dba Coweta County Health Department

  • State or Local Public Health Clinic/Center
  • Newnan, GA
  • NPI 1972598043
  NPD (past)
• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1447245345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7441 MISTYDAWN DR",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302134331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4772 FRONTAGE RD",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302971606",
            "telephone_number": "919-491-9028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGH",
        "first_name": "SHALESE",
        "middle_name": "MCMILLAN",
        "name_prefix": "Ms.",
        "credential": "RD,LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-16",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD002976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Plymouth Point
• PMR Georgia Holding, LLC (Jencare Senior Medical Center Forest Park)
• Reona Yavette Porter, BFS, PPN
• Regina Powell, NP
• Preferential Majestic Group LLC
• Caryn Qian
• Quality Medical Supply and Equp
• Radiance Home Care Services, LLC
• Debra M Reddick, D.D.S
• Prathima Lankala Reddy, M.D.

• Registered Dietitian in Forest Park, GA
• Providers in Forest Park, GA by specialty
• Registered Dietitian in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.