Theresa Elizabeth Shank, RD LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DN004553 Issued in PA

Practice address

1632 Pine St
Philadelphia, PA 19103-6711

Phone

(215) 735-7992

NPI assigned

Jan 21, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  NPD (past)

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

{
    "created_epoch": "1358726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1568700862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 GREEN ST",
            "address_2": "APARTMENT 2N",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303244",
            "telephone_number": "717-203-9728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1632 PINE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036711",
            "telephone_number": "215-735-7992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANK",
        "first_name": "THERESA",
        "middle_name": "ELIZABETH",
        "credential": "RD LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-21",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN004553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trisha Shang, MD
• Mona Marlynn Shangold, M.D.
• Shania's Helper's Home Care
• Dana L Shanis, MD
• Shanita Hinton (Trenet at Home)
• Hari Shankar, M.D.
• Somya Shankar, MD
• Venkat Ramanan Shankar, MD
• Margaret C Shanks, CRNP
• Brianne Shanley, D.M.D.

• Registered Dietitian in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.

Verify at the official NPI Registry.