Shobha Nandivada, RD

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

License

DI100001196 Issued in DC

Practice address

6132 Wheatland Rd
Catonsville, MD 21228-2762

Phone

(347) 982-4372

Fax

(410) 788-1056

NPI assigned

Mar 24, 2010

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

Other names 1

• Miss Shobha Bhudavarapu Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shobhanandivada@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1811211550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10911 MAIDEN DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207203599",
            "telephone_number": "347-982-4372",
            "fax_number": "410-788-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6132 WHEATLAND RD",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212282762",
            "telephone_number": "347-982-4372",
            "fax_number": "410-788-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANDIVADA",
        "first_name": "SHOBHA",
        "name_prefix": "Miss",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-24",
        "last_updated": "2024-06-10",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "DC",
            "license": "DI100001196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHOBHA",
            "last_name": "BHUDAVARAPU",
            "prefix": "MISS",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Nutrition Education Nutritionist in Catonsville, MD
• Providers in Catonsville, MD by specialty
• Nutrition Education Nutritionist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.