Shari Rose Willy, RD, LDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

124742 Issued in KY

Practice address

411 E Chestnut St # 5A6B
Louisville, KY 40202-1713

Phone

(502) 588-4940

Fax

(502) 588-7712

NPI assigned

Jan 23, 2020

Last updated

Jun 24, 2020By 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

Other names 1

• Shari Rose Navis Former name

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Norton Children's Medical Group, LLC

  dba Norton Children's Behavioral and Mental Health

  • Psychiatry Physician
  • Louisville, KY
  • NPI 1457999096
  Medicare reassignment NPD
• Norton Childrens Medical Group, LLC

  dba Norton Children's Medical Group

  • Pediatrics Physician
  • Louisville, KY
  • NPI 1326695255
  NPD (past)

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1669002226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776879",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E CHESTNUT ST # 5A6B",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021713",
            "telephone_number": "502-588-4940",
            "fax_number": "502-588-7712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLY",
        "first_name": "SHARI",
        "middle_name": "ROSE",
        "credential": "RD, LDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KY",
            "license": "124742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARI",
            "last_name": "NAVIS",
            "middle_name": "ROSE",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Willows of Springhurst Opco, LLC (Parr's at Springhurst)
• Lisa Wills-Frank, M.D.
• Lacey Wills
• Rheagan Wills, PHARMD
• Neil Andrew Willsey, R.PH.
• Jessica Nicole Wilmore, MS, CCC-SLP
• Karen Louise Wilsman, AGNP
• Jack T Wilson III, D.M.D.
• Taylor Nicole Wilson Matthews
• Wilson Transportation

• Registered Dietitian in Louisville, KY
• Providers in Louisville, KY by specialty
• Registered Dietitian in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.