Individual provider Active NPI

Shonda Marie Slavec, MS RD LD

  • Registered Dietitian
  • Las Cruces, NM
National Provider Identifier
1659800605
Registry record updated Jun 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD-0936 Issued in NM
Practice address
2455 Missouri Ave Ste a
Las Cruces, NM 88001-5122
Phone
(505) 417-0871
NPI assigned
Jun 5, 2017
Last updated
Jun 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD-0936 NM Primary
Renal Nutrition Registered Dietitian 133VN1005X LD-0936 NM

Addresses

Primary practice location

2455 Missouri Ave Ste a
Las Cruces, NM 88001-5122

Mailing address

4216 Camino Lindo CT
Las Cruces, NM 88011-8434
Phone (505) 417-0871

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LD-0936NMMDRenal Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496620800000",
    "number": "1659800605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4216 CAMINO LINDO CT",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118434",
            "telephone_number": "505-417-0871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 MISSOURI AVE STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880015122",
            "telephone_number": "505-417-0871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLAVEC",
        "first_name": "SHONDA",
        "middle_name": "MARIE",
        "credential": "MS RD LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2017-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NM",
            "license": "LD-0936",
            "primary": true
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "NM",
            "license": "LD-0936",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2017; 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.