Jill Suzanne Shaw, MED, RD, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

916193

Practice address

912 N Elm St
Greensboro, NC 27401-1513

Phone

(336) 455-2358

NPI assigned

Mar 2, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1871188789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8109 MOORES MILL CT",
            "city": "STOKESDALE",
            "state": "NC",
            "postal_code": "273579484",
            "telephone_number": "336-613-1347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011513",
            "telephone_number": "336-455-2358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JILL",
        "middle_name": "SUZANNE",
        "credential": "MED, RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "916193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shameka Majel 'Anndeshay Sharpe
• Colleen E Shaw, LCSW
• Erin Christine Shaw, M.D.
• Eva Nicolene Proescholdt Shaw, M.D.
• Inez Gooden Shaw, RN
• Jo Ann G. Shaw, M.D.
• William Douglas Shaw, Jr., MD
• Kimberlee Shaw, MD
• Kimberly Dawn Shaw, CNM
• Robert Boyd Shaw Jr., L.P.C.

• Registered Dietitian in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.