Active NPI
Julie Shimko, RD
- Registered Dietitian
- Santa Rosa, CA
National Provider Identifier
1457849697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86045793
- Practice address
- 1007B W College Ave # 198
Santa Rosa, CA 95401-5029 - Phone
- (707) 509-0226
- Fax
- (844) 322-4726
- NPI assigned
- Apr 24, 2018
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 86045793 | CA | |
| Nutrition Education Nutritionist | 133NN1002X | |||
| Oncology Nutrition Registered Dietitian | 133VN1301X | |||
| Registered Dietitian | 133V00000X | 86045793 | CA | Primary |
Addresses
Primary practice location
1007B W College Ave # 198
Santa Rosa, CA 95401-5029
Mailing address
469 W Spain St
Sonoma, CA 95476-5624
Phone (773) 603-1618
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 |
|---|---|---|---|
| 86045793 | CA | MD | Nutritionist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| As You Are Nutrition Inc | Dietitian, Registered | Current | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
Locations
1443 Main St
Ste 130B
Napa, CA 94559
Phone (707) 200-1178
Organizations & group practices 3
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": "1524528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600732800000",
"number": "1457849697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "469 W SPAIN ST",
"city": "SONOMA",
"state": "CA",
"postal_code": "954765624",
"telephone_number": "773-603-1618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1007B W COLLEGE AVE # 198",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954015029",
"telephone_number": "707-509-0226",
"fax_number": "844-322-4726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIMKO",
"first_name": "JULIE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-24",
"last_updated": "2020-09-22",
"certification_date": "2020-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "CA",
"license": "86045793",
"primary": false
},
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": null,
"license": null,
"primary": false
},
{
"code": "133VN1301X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Oncology",
"state": null,
"license": null,
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86045793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.