Individual provider Active NPI

Shannon Marie Rentz, RD, LD

  • Registered Dietitian
  • Portland, OR
National Provider Identifier
1831231059
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
579 Issued in OR
Practice address
Oregon Health & Sciences University, Mail Code Uhs 18
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3098
Phone
(503) 494-8636
Fax
(503) 494-3769
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 579 OR Primary

Addresses

Primary practice location

Oregon Health & Sciences University, Mail Code Uhs 18
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3098

Mailing address

2333 SE Cleveland Ave
Gresham, OR 97080-6380
Phone (503) 494-8636

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
579ORMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831231059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 SE CLEVELAND AVE",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970806380",
            "telephone_number": "503-494-8636",
            "fax_number": "503-494-3769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "OREGON HEALTH & SCIENCES UNIVERSITY, MAIL CODE UHS 18",
            "address_2": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393098",
            "telephone_number": "503-494-8636",
            "fax_number": "503-494-3769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENTZ",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.