Shae M Mowry

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164.007492 Issued in IL

Practice address

319 E Madison St Ste 1F
Springfield, IL 62701-3118

Phone

(217) 788-3948

Fax

(217) 527-3209

NPI assigned

Oct 21, 2021

Last updated

Oct 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shae M Hoffman Former name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Medical CenterGroup PAC ID 7315835949, 131 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shaemowry@sfc.allscriptsdirect.net
• Direct secure messaging: shaemowry@memorial.allscriptsdirect.net

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

• Memorial Medical Center

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1033171343
  Medicare reassignment Care Compare group NPD
• Memorial Health Partners

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1376034744
  NPD
• Memorial Medical Center

  dba The Hearing Center at Memorial

  • Audiologist
  • Springfield, IL
  • NPI 1679549968
  NPD
• Springfield Clinic LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1215974415
  NPD

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1851054258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3428",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627083428",
            "telephone_number": "217-588-2624",
            "fax_number": "217-757-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 E MADISON ST STE 1F",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627013118",
            "telephone_number": "217-788-3948",
            "fax_number": "217-527-3209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOWRY",
        "first_name": "SHAE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-21",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.007492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RD LICENSE",
            "identifier": "164.007492",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAE",
            "last_name": "HOFFMAN",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hannah Motley
• Isabella Mott, RBT
• Gaylan Wayne Moushon, O.D.
• Joanne G. Moussette, PSY.D.
• Lindsay Ryanna Mowen, M.S., CCC-SLP/L
• Lacey Dively Moy, MD
• MPM Physical Therapy PLLC (Restore Core Therapy and Pelvic Health)
• Sajjad Mueed, M.D.
• Casey Muehle, MD
• Julie A. Mueller, R.N.

• Registered Dietitian in Springfield, IL
• Providers in Springfield, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.