Active NPI
Shelley Glaze
- Nutritionist
- Oregon City, OR
National Provider Identifier
1558768697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- Practice address
- 998 Library CT
Oregon City, OR 97045-4041 - Phone
- (503) 655-8476
- Fax
- (503) 655-8387
- NPI assigned
- Dec 3, 2014
- 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 |
|---|---|---|---|---|
| Nutritionist | 133N00000X | OR | Primary |
Addresses
Primary practice location
998 Library CT
Oregon City, OR 97045-4041
Mailing address
998 Library CT
Oregon City, OR 97045-4041
Phone (503) 655-8476
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clackamas County | Past | Accepting new patients | |
| County of Clackamas Office of County Auditor | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Federally Qualified Health Center (FQHC)
- Oregon City, OR
- NPI 1841443587
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Milwaukie, OR
- NPI 1245269315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417564800000",
"number": "1558768697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "998 LIBRARY CT",
"city": "OREGON CITY",
"state": "OR",
"postal_code": "970454041",
"telephone_number": "503-655-8476",
"fax_number": "503-655-8387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "998 LIBRARY CT",
"city": "OREGON CITY",
"state": "OR",
"postal_code": "970454041",
"telephone_number": "503-655-8476",
"fax_number": "503-655-8387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLAZE",
"first_name": "SHELLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-03",
"last_updated": "2014-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oregon City, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.