Individual provider Active NPI

Rosalie Tierney, RD

  • Registered Dietitian
  • Bend, OR
National Provider Identifier
1942830559
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD-D-10218001 Issued in OR
Practice address
369 NE Revere Ave Ste 105
Bend, OR 97701-4082
Phone
(541) 323-3488
Fax
(541) 323-3483
NPI assigned
Jan 22, 2020
Last updated
Nov 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD-D-10218001 OR Primary
Health Educator 174H00000X

Addresses

Primary practice location

369 NE Revere Ave Ste 105
Bend, OR 97701-4082

Mailing address

369 NE Revere Ave Ste 105
Bend, OR 97701-4082
Phone (541) 323-3488

Other names 1

  • Rosalie Shanks Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230830000943 OR Practitioner - Registered Dietitian Or Nutrition Professional 0244693836 Reassigns benefits to 1 organization
I20260626004622 DC Practitioner - Registered Dietitian Or Nutrition Professional 0244693836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Randee Anshutz Nutrition and Massage TherapyGroup PAC ID 2769785609, 6 clinicians

Practice addresses (Care Compare)

369 NE Revere Ave
Suite 105
Bend, OR 97701-4082
Phone (541) 323-3488

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
LD-D-10218001ORMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Randee Anshutz Nutrition and Massage Therapy CurrentSince Jul 5, 2023 Accepting new patients

Locations

361 NE Franklin Ave
Bldg C
Bend, OR 97701
Phone (541) 323-3488

369 NE Revere Ave
Ste 105
Bend, OR 97701
Phone (541) 323-3488

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764115200000",
    "number": "1942830559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 NE REVERE AVE STE 105",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014082",
            "telephone_number": "541-323-3488",
            "fax_number": "541-323-3483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 NE REVERE AVE STE 105",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014082",
            "telephone_number": "541-323-3488",
            "fax_number": "541-323-3483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIERNEY",
        "first_name": "ROSALIE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-22",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-10218001",
            "primary": true
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSALIE",
            "last_name": "SHANKS",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2025; 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.