Crystal Marie Shores, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD003806 Issued in GA

Practice address

5150 Davidson Road
Marietta, GA 30068

Phone

(678) 209-8976

NPI assigned

Jan 5, 2012

Last updated

Jan 5, 2012By the provider in NPPES

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1629348727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4880 LOWER ROSWELL RD",
            "address_2": "SUITE 165-142",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684375",
            "telephone_number": "678-209-8976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 DAVIDSON ROAD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30068",
            "telephone_number": "678-209-8976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORES",
        "first_name": "CRYSTAL",
        "middle_name": "MARIE",
        "credential": "RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-05",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD003806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anita Joy Shoemo, CERTIFIED PHLEBOTOMY
• Lance David Sholes, PHARMD
• Courtney Belle Shook, LPC
• Richard E Shook, PH.D.
• Vera Melinda Shook, LPN
• Savannah Lauren Short, DMD
• Sahir G Shroff, M.D.
• Shu-Re-Nu Equipment Inc. (Footlabs)
• Li Hua Shu, LICENSE ACUPUNCTURIS
• Shubhang Mazumdar MD

• Registered Dietitian in Marietta, GA
• Providers in Marietta, GA by specialty
• Registered Dietitian in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; 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.