Shanti A Wolfe-Payton, RD
Individual provider Active NPI Registered Dietitian · Sparks, NV
NPI 1457790156 · NPPES record last updated Jun 17, 2013
Key facts
- NPI
- 1457790156
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 1043031 (NV)
- Practice address
- 1861 Spring Blossom LN
Sparks, NV 89434-8093 - Phone
- (775) 223-5104
- NPI assigned
- Jun 17, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1043031 | NV | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1043031 | NV | Yes |
Addresses
Primary practice location
1861 Spring Blossom LN
Sparks, NV 89434-8093
Mailing address
1861 Spring Blossom LN
Sparks, NV 89434-8093
Phone (775) 223-5104
Other providers in Sparks, NV
- Lorraine Kay Wirkus
- Seana Rae Wishart-NG
- Jacob Richard Wiskerchen Jr.
- Ulrich Wohlfahrt
- Aaron David Wolfe-Payton
- Jeanne Marie Wontkowski
- Angelica Wood Amador
- Elvira Wood
- Joshua Harland Wood
- Kendal Wood
All providers in Sparks, NV · Registered Dietitian in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.