Shannon Davis, MS, RD
Individual provider Active NPI Registered Dietitian · Hartwick, NY
NPI 1780123646 · NPPES record last updated Feb 13, 2017
Key facts
- NPI
- 1780123646
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 8674081 (NY)
- Practice address
- 4340 State Highway 80
Hartwick, NY 13348-2714 - Phone
- (607) 547-8286
- NPI assigned
- Feb 13, 2017
- 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)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8674081 | NY | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 8674081 | NY | Yes |
Addresses
Primary practice location
4340 State Highway 80
Hartwick, NY 13348-2714
Mailing address
4340 State Highway 80
Hartwick, NY 13348-2714
Other providers in Hartwick, NY
- Jennifer Bowen
- Kathy M Broten
- Karrie Crippen
- Jody Kenyon, LCSW-R Counseling Services
- Maranatha Mission Home Network, Inc
- Tina McLean
- MRH Counseling
- Loraine Robla Nicholson
All providers in Hartwick, NY · Registered Dietitian in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.