Individual provider Active NPI

Carey Shore, RD-LD

  • Registered Dietitian
  • Flower Mound, TX
National Provider Identifier
1922487719
Registry record updated May 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT83624 Issued in TX
Practice address
3051 Churchill Dr
Suite 130
Flower Mound, TX 75022-2713
Phone
(972) 539-0086
Fax
(972) 355-9680
NPI assigned
May 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2015

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 DT83624 TX Primary

Addresses

Primary practice location

3051 Churchill Dr
Suite 130
Flower Mound, TX 75022-2713

Mailing address

3051 Churchill Dr
Suite 130
Flower Mound, TX 75022-2713
Phone (972) 539-0086

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DT83624TXMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Faac, PA PastSince Jan 1, 1997 Accepting new patients
Kma Radiology, PA Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432598400000",
    "number": "1922487719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 CHURCHILL DR",
            "address_2": "SUITE 130",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750222713",
            "telephone_number": "972-539-0086",
            "fax_number": "972-355-9680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3051 CHURCHILL DR",
            "address_2": "SUITE 130",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750222713",
            "telephone_number": "972-539-0086",
            "fax_number": "972-355-9680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "CAREY",
        "credential": "RD-LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-26",
        "last_updated": "2015-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT83624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; 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.