Charissa Sue Shadduck, MS RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

3181 Sandhill Rd
Mason, MI 48854

Phone

(517) 336-6060

Fax

(517) 336-6050

NPI assigned

Sep 20, 2007

Sex

Female

Sole proprietor

No

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

Enrolled in MI

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Mental Health Authority of Clinton Eaton Ingham CountiesGroup PAC ID 2668376732, 78 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Community Mental Health Authority of Clinton Eaton Ingham Counties

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lansing, MI
  • NPI 1265483457
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1629264973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SANDHILL RD",
            "city": "MASON",
            "state": "MI",
            "postal_code": "48854",
            "telephone_number": "517-336-6060",
            "fax_number": "517-336-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SANDHILL RD",
            "city": "MASON",
            "state": "MI",
            "postal_code": "48854",
            "telephone_number": "517-336-6060",
            "fax_number": "517-336-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADDUCK",
        "first_name": "CHARISSA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "MS RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-20",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Schreier
• Marcie Schwartz, NP
• Annalise Score
• Sequence Care Management, Inc
• Serenity Counseling Services and Therapeutic Martial Arts LLC
• Elizabeth Paige Shafer, PT, DPT
• David Edward Shellenbarger, LPC
• Marissa Sherouse
• Stacey L Siminski, LLMSW
• Richard J. Sims, O.D.

• Registered Dietitian in Mason, MI
• Providers in Mason, MI by specialty
• Registered Dietitian in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.