Shannon Marie Martin, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86079255

Practice address

6505 Market St
Boardman, OH 44512-3457

Phone

(330) 746-8100

NPI assigned

Jun 20, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1750377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1992692008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 AFTON AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445122404",
            "telephone_number": "724-301-6913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 MARKET ST",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445123457",
            "telephone_number": "330-746-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-20",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": null,
            "license": "86079255",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "86079255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Market Street Spine & Rehab, LLC
• Scott Alan Marlin, MA, LSW
• April L Maro, RN
• April Martin
• Don Martin, PHD
• Tiffany Lynn Martino, LPN
• Jason T Marucci, D.C.
• Masco, Inc
• Jack Russell Mashburn, HAS
• Cadi Jane Masi, BA, BCABA

• Registered Dietitian in Boardman, OH
• Providers in Boardman, OH by specialty
• Registered Dietitian in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; 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.