Active NPI
Shelby Jay Sackett, RD, LD
- Registered Dietitian
- Saint Paul, MN
National Provider Identifier
1790102358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1120
- Practice address
- 1045 Westgate Dr
Suite 100
Saint Paul, MN 55114-1000 - Phone
- (651) 605-2324
- NPI assigned
- Mar 20, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1120 | MN | Primary |
Addresses
Primary practice location
1045 Westgate Dr
Suite 100
Saint Paul, MN 55114-1000
Mailing address
1045 Westgate Dr
Suite 100
Saint Paul, MN 55114-1000
Phone (651) 605-2324
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395273600000",
"number": "1790102358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1045 WESTGATE DR",
"address_2": "SUITE 100",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551141000",
"telephone_number": "651-605-2324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1045 WESTGATE DR",
"address_2": "SUITE 100",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551141000",
"telephone_number": "651-605-2324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SACKETT",
"first_name": "SHELBY",
"middle_name": "JAY",
"credential": "RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-20",
"last_updated": "2014-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MN",
"license": "1120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.