Shannon Moira Sullivan, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT86901 Issued in TX

Practice address

8700 Menchaca Rd Ste 806
Austin, TX 78748-5379

Phone

(254) 290-2183

NPI assigned

Jun 15, 2023

Last updated

Jun 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Practice roles

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.

• Amreen Bora, Rd LLC

  dba Bora Nutrition

  • Registered Dietitian
  • West Lake Hills, TX
  • NPI 1851048052

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1699450858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W SAINT ELMO RD APT 1007",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787453316",
            "telephone_number": "254-290-2183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 MENCHACA RD STE 806",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787485379",
            "telephone_number": "254-290-2183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SHANNON",
        "middle_name": "MOIRA",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT86901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Elizabeth Sullivan, LPC
• Gabrielle Sullivan
• Julie Sullivan
• Kimberlee Dawn Sullivan, DPT
• Ryan Christopher Sullivan, LCSW
• Catherine Hughes Sult, LMFT-ASSOCIATE
• Mohammad Yousuf Sultani, DDS
• Paulgun Sulur, M.D.
• Jillian Brooke Summar
• Janelle Summerkamp, PT

• Registered Dietitian in Austin, TX
• Providers in Austin, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.