Kelly Shaughnessy, RD BS

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1073135 Issued in CA

Practice address

749 Teaberry St
Encinitas, CA 92024-3353

Phone

(661) 993-8710

NPI assigned

Nov 19, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

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.

• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824

  Dietitian, Registered

  Medicare reassignment NPD

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1528604113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3724 JEFFERSON ST STE 104",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316204",
            "telephone_number": "512-693-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 TEABERRY ST",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920243353",
            "telephone_number": "661-993-8710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "749 Teaberry St",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920243353",
            "country_code": "US",
            "telephone_number": "661-993-8710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAUGHNESSY",
        "first_name": "KELLY",
        "credential": "RD BS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1073135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "OhMDKellyShaughnessyRDToHealth",
            "affiliation": "N",
            "endpointDescription": "OhMD app under Kelly Shaughnessy RD To Health",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Information share",
            "address_1": "749 Teaberry St",
            "city": "Encinitas",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920243353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Puja Shah, D.M.D.
• Sagar Kamlesh Shah, MD
• Ali Shahrokh, DMD
• Stephanie Si-Yu Shao, LCSW
• John Alan Sharkey, MMS, PA-C
• Erika Katherine Shaw, L.AC, DACM, CMT
• Kevin Daniel Shaw, M.D
• Paula Hollis Shaw, CADC L
• Maurice Michael Sheehan, NP
• Emily Sheets, BCBA

• Registered Dietitian in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.