Active NPI
Shawn Idell, RD, LD
- Registered Dietitian
- Durant, OK
National Provider Identifier
1942654819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 509
- Practice address
- 1800 W University Blvd
Durant, OK 74701-3006 - Phone
- (580) 924-3080
- Fax
- (580) 931-2048
- NPI assigned
- Apr 18, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 509 | OK | Primary |
Addresses
Primary practice location
1800 W University Blvd
Durant, OK 74701-3006
Mailing address
1800 W University Blvd
Durant, OK 74701-3006
Phone (580) 924-3080
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 509 | OK | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Current | Accepting new patients |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
Locations
2820 NE 214th St
Ste 801
Miami, FL 33180
Phone (305) 204-9877
500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000
3724 Jefferson St
Ste 104
Austin, TX 78731
Phone (512) 399-9039
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": "1460937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460937600000",
"number": "1942654819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 W UNIVERSITY BLVD",
"city": "DURANT",
"state": "OK",
"postal_code": "747013006",
"telephone_number": "580-924-3080",
"fax_number": "580-931-2048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 W UNIVERSITY BLVD",
"city": "DURANT",
"state": "OK",
"postal_code": "747013006",
"telephone_number": "580-924-3080",
"fax_number": "580-931-2048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IDELL",
"first_name": "SHAWN",
"credential": "RD, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-18",
"last_updated": "2016-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durant, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.