Shape Shifters Weight Loss and Joint Center

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

SHAPE SHIFTERS WEIGHT LOSS AND JOINT CENTER

Practice address

104 University Pkwy Ste 1
Johnson City, TN 37604-7349

Phone

(423) 335-3077

NPI assigned

Dec 26, 2019

Organization subpart

No

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

Authorized official

Name

Ms. Mary Beth Byrd, APRNNPI 1013387349

Title

Owner

Phone

(423) 335-3077

Specialties & licenses 1

Addresses

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23099/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Beth Byrd, FNP

  • Family Nurse Practitioner
  • Erwin, TN
  • NPI 1013387349
  NPD Authorized official

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

{
    "created_epoch": "1577318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577318400000",
    "number": "1932748829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 UNIVERSITY PKWY STE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376047349",
            "telephone_number": "423-335-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 UNIVERSITY PKWY STE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376047349",
            "telephone_number": "423-335-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAPE SHIFTERS WEIGHT LOSS AND JOINT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-26",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A",
        "authorized_official_last_name": "BYRD",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-335-3077",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Shankel, RN BSN
• Victoria Shankle, DO
• Shannon Myers DC LLC
• Hannah T Shannon, LPC/ MHSP
• James Patrick Shannon Jr., DC
• Rebecca S Sharish, MD
• Kimberly Sharitz, M.S. CCC-SLP
• Trishna Sharma, MBBS
• Amy Leigh Shaw, APRN
• Mellissa Kay Shaw, LPN

• Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2019; 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.