Tracey Lynn Shaffer, R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2007003698 Issued in MO

Practice address

4009 NE Grant St
Lees Summit, MO 64064-7884

Phone

(816) 226-7667

NPI assigned

Apr 30, 2010

Reactivated

Jun 14, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 8

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Openloop Healthcare Partners PC

  • General Practice Physician
  • Des Moines, IA
  • NPI 1245820661

  Dietitian, Registered

  NPD
• Albany ENT & Allergy Services PC

  • Otolaryngology Physician
  • Albany, NY
  • NPI 1205838729
  NPD (past)
• Openloop Healthcare Partners California PC

  • General Practice Physician
  • Palm Desert, CA
  • NPI 1659042331

  Dietitian, Registered

  NPD (past)
• Openloop Healthcare Partners Wisconsin, SC

  • General Practice Physician
  • Madison, WI
  • NPI 1083371629

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1487971339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 830242",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191820242",
            "telephone_number": "615-425-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 NE GRANT ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640647884",
            "telephone_number": "816-226-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "TRACEY",
        "middle_name": "LYNN",
        "credential": "R.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-30",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "deactivation_date": "2013-05-13",
        "reactivation_date": "2013-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "10220695",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "6059-29",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI61281597",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "DX5577",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2007003698",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "09740",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT87459",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "2710",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serc Rehabilitation Partners, LLC
• Inessa Izyevna Sergeyeva, FNP-BC
• John Paul Sevcik, DPM
• Georgia Severns, LPN
• Annmarie Lenae Shackelford, OT
• Sahil Rajesh Shah, MD
• Jeanette Marjorie Shanholtzer, RNC MSN APRN WHNP
• Mackenzie Nicole Shanks, MS, PLPC, NCC
• Sharen Kauzlarich DC, PC
• Sharp Medical Equipment Inc

• Registered Dietitian in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Registered Dietitian in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; 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.