Wellness Center at Shady Grove Fertility, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

WELLNESS CENTER AT SHADY GROVE FERTILITY, LLC

Practice address

9601 Blackwell Road
Suite 500
Rockville, MD 20850-6478

Phone

(888) 604-7525

NPI assigned

May 29, 2018

Organization subpart

Yes

Parent organization

SHADY GROVE FERTILITY, LLCAs reported in NPPES

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

Authorized official

Name

Shelly Shapiro

Title

Chief Financial Officer

Phone

(301) 545-1407

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527552000000",
    "number": "1891286530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 BLACKWELL RD STE 500",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503783",
            "telephone_number": "301-340-1188",
            "fax_number": "301-340-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 BLACKWELL ROAD",
            "address_2": "SUITE 500",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506478",
            "telephone_number": "888-604-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS CENTER AT SHADY GROVE FERTILITY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHADY GROVE FERTILITY, LLC",
        "enumeration_date": "2018-05-29",
        "last_updated": "2018-05-29",
        "status": "A",
        "authorized_official_last_name": "SHAPIRO",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "301-545-1407"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Rockville, MD
• Providers in Rockville, MD by specialty
• Registered Dietitian in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; 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.