Individual provider Active NPI

Josie Colleen Showalter

  • Registered Dietitian
  • Portland, OR
National Provider Identifier
1649167305
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
2175 NW Raleigh St Ste 110
Portland, OR 97210-2392
Phone
(602) 218-5278
Fax
(844) 218-4691
NPI assigned
Jun 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

2175 NW Raleigh St Ste 110
Portland, OR 97210-2392

Mailing address

70 S Val Vista Dr # A3-527
Gilbert, AZ 85296-1374

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250818001583 AZ Practitioner - Registered Dietitian Or Nutrition Professional 4082113014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

428 S Gilbert Rd
Suite 106 2
Gilbert, AZ 85296-2261

500 Boston Post Rd
Orange, CT 06477-3530

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Dietitian Group LLC Dietitian, Registered CurrentSince Jun 18, 2025 Accepting new patients

Locations

428 S Gilbert Rd
Ste 1062
Gilbert, AZ 85296
Phone (602) 218-4691

122 E Main St
Medford, OR 97501

2175 NW Raleigh St
Ste 110
Portland, OR 97210
Phone (971) 238-2369

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1649167305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 S VAL VISTA DR # A3-527",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 NW RALEIGH ST STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102392",
            "telephone_number": "602-218-5278",
            "fax_number": "844-218-4691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOWALTER",
        "first_name": "JOSIE",
        "middle_name": "COLLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; 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.