Shannon Terry Carrigan, RD/LD ,MS

Individual provider Active NPI Registered Dietitian · Palatka, FL

NPI 1710551981 · NPPES record last updated May 13, 2021

Key facts

NPI
1710551981
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
ND3920 (FL)
Practice address
2801 Kennedy St
Palatka, FL 32177-4150
Phone
(386) 326-3200
Fax
(386) 326-3399
NPI assigned
May 13, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X ND3920 FL Yes

Addresses

Primary practice location

2801 Kennedy St
Palatka, FL 32177-4150

Mailing address

144 Edgewater Rd
Satsuma, FL 32189-2116
Phone (386) 327-3287

Other practice location 1

144 Edgewater Rd
Satsuma, FL 32189-2116
Phone (386) 237-2387

Electronic endpoints

TypeEndpointUseAffiliation
SOAP URL Computer Health Information Exchange (HIE)
SOAP URL Computer Health Information Exchange (HIE)

Other providers in Palatka, FL

All providers in Palatka, FL · Registered Dietitian in Florida

Sources for this page

Verify at the official NPI Registry.