Active NPI
Shannon Smith, RD
- Registered Dietitian
- Chandler, AZ
National Provider Identifier
1922636810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 921653
- Practice address
- 1955 W Frye Rd
Chandler, AZ 85224-6282 - Phone
- (480) 728-3000
- NPI assigned
- Mar 28, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 921653 | IL | Primary |
Addresses
Primary practice location
1955 W Frye Rd
Chandler, AZ 85224-6282
Mailing address
1516 E Rovey Ave Apt 6
Phoenix, AZ 85014-2441
Phone (214) 606-9056
Other practice location 1
1930 E Thomas Rd
Phoenix, AZ 85016-7711
Phone (602) 532-1000
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
| License | State | Type | Specialty |
|---|---|---|---|
| 921653 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585353600000",
"number": "1922636810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1516 E ROVEY AVE APT 6",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850142441",
"telephone_number": "214-606-9056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1955 W FRYE RD",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852246282",
"telephone_number": "480-728-3000"
}
],
"practiceLocations": [
{
"address_1": "1930 E Thomas Rd",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850167711",
"country_code": "US",
"telephone_number": "602-532-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "SHANNON",
"name_prefix": "Dr.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-28",
"last_updated": "2020-03-28",
"certification_date": "2020-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "921653",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chandler, AZ
- Paula Fitzgerald Smith, FNP
- Payten A Smith, MOT
- Savannah Smith, LCSW
- Sean Woodson Smith, PA-C
- Shaniah Quozette Smith, BCBA, LBA
- Yesenia Smith
- Smiths Food & Drug Centers Inc (Frys Food and Drug)
- Smiths Food & Drug Centers Inc (Fry's Pharmacy #681)
- Smiths Food & Drug Centers Inc (Frys Food and Drug)
- Smiths Food & Drug Centers Inc (Frys Food and Drug)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.