Nancy B Shafa, RD, CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

200 Muir Rd
Martinez, CA 94553-4614

Phone

(925) 372-1309

NPI assigned

Dec 19, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1811050628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308-D BOULEVARD WAY",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945951200",
            "telephone_number": "925-372-1309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MUIR RD",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945534614",
            "telephone_number": "925-372-1309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFA",
        "first_name": "NANCY",
        "middle_name": "B",
        "credential": "RD, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3400 Delta Fair Blvd",
            "city": "Antioch",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Registered Dietitian in Martinez, CA
• Providers in Martinez, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.