Shannon Powers-Jones, RD, LDN

Individual provider Active NPI Registered Dietitian · Tega Cay, SC

NPI 1609265479 · NPPES record last updated Jan 16, 2015

Key facts

NPI
1609265479
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
L004175 (NC)
Practice address
1743 Bentgrass LN
Tega Cay, SC 29708-8537
Phone
(803) 396-0935
NPI assigned
Jan 16, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
L004175NCMDRegistered Dietitian
1289SCMDOptometrist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X L004175 NC Yes
Registered Dietitian 133V00000X 1289 SC

Addresses

Primary practice location

1743 Bentgrass LN
Tega Cay, SC 29708-8537

Mailing address

1743 Bentgrass LN
Tega Cay, SC 29708-8537
Phone (803) 396-0935

Other providers in Tega Cay, SC

All providers in Tega Cay, SC · Registered Dietitian in South Carolina

Sources for this page

Verify at the official NPI Registry.