Individual provider Active NPI

Shelby Ann Straley, RDN

  • Registered Dietitian
  • Stansbury Park, UT
National Provider Identifier
1922831114
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86068397 Issued in UT
Practice address
576 Ut-138 #400
Stansbury Park, UT 84074
Phone
(435) 833-9070
NPI assigned
Aug 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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 86068397 UT Primary

Addresses

Primary practice location

576 Ut-138 #400
Stansbury Park, UT 84074

Mailing address

235 Spyglass Dr
Stansbury Park, UT 84074-9634
Phone (435) 228-8304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240914000111 UT Practitioner - Registered Dietitian Or Nutrition Professional 8123568300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pagnani Physical TherapyGroup PAC ID 9537433388, 8 clinicians

Practice addresses (Care Compare)

2321 N 400
Suite 400
Tooele, UT 84074-3440
Phone (435) 833-9070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86068397UTMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Tooele Clinic Corp CurrentSince Sep 4, 2024 Accepting new patients
Pagnani Physical Therapy CurrentSince Sep 4, 2024 Accepting new patients

Locations

2321 N 400 E
Ste 400
Tooele, UT 84074
Phone (435) 553-4969

576 E Highway 138
Ste 400
Tooele, UT 84074
Phone (435) 833-9070

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": "1724284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1922831114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 SPYGLASS DR",
            "city": "STANSBURY PARK",
            "state": "UT",
            "postal_code": "840749634",
            "telephone_number": "435-228-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 UT-138 #400",
            "city": "STANSBURY PARK",
            "state": "UT",
            "postal_code": "84074",
            "telephone_number": "435-833-9070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRALEY",
        "first_name": "SHELBY",
        "middle_name": "ANN",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-22",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "UT",
            "license": "86068397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stansbury Park, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.