Individual provider Active NPI

Shannon Miller Lehman, RDN

  • Registered Dietitian
  • Fort Walton Beach, FL
National Provider Identifier
1679360325
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND-12637 Issued in FL
Practice address
51 Yacht Club Dr NE Ste a
Fort Walton Beach, FL 32548-4440
Phone
(803) 238-3863
NPI assigned
Apr 24, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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 012140-01 NY
Registered Dietitian 133V00000X ND-12637 FL Primary

Addresses

Primary practice location

51 Yacht Club Dr NE Ste a
Fort Walton Beach, FL 32548-4440

Mailing address

51 Yacht Club Dr NE Ste a
Fort Walton Beach, FL 32548-4440
Phone (803) 238-3863

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

State licenses

LicenseStateTypeSpecialty
ND-12637FLMDRegistered Dietitian
012140-01NYMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1745452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1679360325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 YACHT CLUB DR NE STE A",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484440",
            "telephone_number": "803-238-3863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 YACHT CLUB DR NE STE A",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484440",
            "telephone_number": "803-238-3863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER LEHMAN",
        "first_name": "SHANNON",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "012140-01",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND-12637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; 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.