Active NPI
Shannon Marie Slavik, R.D.
- Registered Dietitian
- San Diego, CA
National Provider Identifier
1528187671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 917987
- Practice address
- 4647 Zion Ave
San Diego, CA 92120-2507 - Phone
- (619) 528-5302
- Fax
- (619) 528-6818
- NPI assigned
- Mar 28, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 917987 | CA | Primary |
Addresses
Primary practice location
4647 Zion Ave
San Diego, CA 92120-2507
Mailing address
3745 7TH Ave
Apt 4
San Diego, CA 92103-4334
Phone (858) 361-6052
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 917987 | CA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528187671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3745 7TH AVE",
"address_2": "APT 4",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921034334",
"telephone_number": "858-361-6052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4647 ZION AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921202507",
"telephone_number": "619-528-5302",
"fax_number": "619-528-6818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLAVIK",
"first_name": "SHANNON",
"middle_name": "MARIE",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "917987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.