Kyle Michael Shomaker, CDM, CFPP

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

License

312779716 Issued in GA

Practice address

1061 Harmon Ave BLDG 302
Fort Stewart, GA 31314-5641

Phone

(912) 435-6739

Fax

(912) 435-6923

NPI assigned

Sep 19, 2014

Sex

Male

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

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411084800000",
    "number": "1710389986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "address_2": "BUILDING 302",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-435-6739",
            "fax_number": "912-435-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE BLDG 302",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-435-6739",
            "fax_number": "912-435-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOMAKER",
        "first_name": "KYLE",
        "middle_name": "MICHAEL",
        "credential": "CDM, CFPP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-19",
        "last_updated": "2014-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "GA",
            "license": "312779716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Sheehan, CNA
• Joshua Heath Shehan, PA-C
• Beatrice Kay Shepard, LCSW
• Katina Lynniece Shine, PH.D.
• Sheldon Shishido, PT, DPT, OCS, CSCS
• Ashton Graham Short, DMD
• Mariaeugenia Sierra-Donovan, PA
• Zorana M Sifford, M.D.
• Dusti Sikes, RN, CRNA, DNP
• Dana Simbras, LPN

• Nutrition Education Nutritionist in Fort Stewart, GA
• Providers in Fort Stewart, GA by specialty
• Nutrition Education Nutritionist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; 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.