Active NPI
Shannon Keefe, MS
- Nutritionist
- Berkeley, CA
National Provider Identifier
1568202703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- Practice address
- 1625 62ND St
Berkeley, CA 94703-2603 - Phone
- (785) 331-6839
- NPI assigned
- May 27, 2024
- 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 | Primary |
Addresses
Primary practice location
1625 62ND St
Berkeley, CA 94703-2603
Mailing address
1625 62ND Street
Berkeley, CA 94703
Phone (785) 331-6839
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716768000000",
"number": "1568202703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1625 62ND STREET",
"city": "BERKELEY",
"state": "CA",
"postal_code": "94703",
"telephone_number": "785-331-6839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1625 62ND ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947032603",
"telephone_number": "785-331-6839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEEFE",
"first_name": "SHANNON",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-27",
"last_updated": "2024-05-27",
"certification_date": "2024-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.