MRS. KRISTEN NICOLE SHORES (NPI# 1720605900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720605900 |
| Entity Type | Individual |
| Full Name | MRS. KRISTEN NICOLE SHORES |
| Credential | RDN |
| Practice Address |
150 E Siebenmorgen Rd Conway AR 72032-4000 |
| Mailing Address |
33 Waycross Dr Greenbrier AR 72058-8525 |
| Practice Telephone | 5013296851 |
| Mailing Telephone | 5012692474 |
| Enumeration Date | 2020-07-03 |
| Last Update Date | 2020-07-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174032262 | Kristen Shores | Speech-Language Pathologist | 1 Baker Pl, Keyser, WV 26726-2824 | 2017-09-21 |
| 1740565647 | Kristen M Shores | Social Worker | 640 W Market St, Akron, OH 44303-1413 | 2011-10-12 |
| 1457684854 | Kristen Lynn Shores | Speech-Language Pathologist | 4650 Mcmasters Ave, Hannibal, MO 63401-2244 | 2009-09-16 |
| 1942460241 | Kristen Brooke Shores | Skilled Nursing Facility | 34 Gracey St, Sparta, TN 38583-2046 | 2008-06-11 |
| Street Address |
150 E SIEBENMORGEN RD |
| City | CONWAY |
| State | AR |
| Zip Code | 72032-4000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225568272 | Dustin Luke Van Pelt | Nurse Practitioner | 150 E Siebenmorgen Rd, Conway, AR 72032-4000 | 2017-06-13 |
| 1811505803 | Larreasha Kentoria Adams | Nurse Practitioner | 150 E Siebenmorgen Rd, Conway, AR 72032-4000 | 2020-07-16 |
| 1699393603 | Lindsey Brooke Woodall | Nurse Practitioner | 150 E Siebenmorgen Rd, Conway, AR 72032-4000 | 2020-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730789843 | Amelia S Lasater | Pharmacist | 1155 Hwy 65n, Conway, AR 72032 | 2020-10-28 |
| 1619584604 | Danyelle Durocher | Occupational Therapist | 1301 North Museum Rd, Conway, AR 72032 | 2020-09-24 |
| 1780222174 | Eric Herman Boxnick | Pharmacist | 101 West Oak Street, Conway, AR 72032 | 2019-12-16 |
| 1932746070 | Habilitation Center, LLC | Psychiatric Residential Treatment Facility | 161 Skunk Hollow Road, Conway, AR 72032 | 2019-12-09 |
| 1679051668 | Mary Elizabeth Black | Nurse Practitioner | 222 Dave Ward Drive, Conway, AR 72032 | 2018-08-01 |
| 1275035602 | Conway Dental Center Pllc | Dentist | 1600 E. Oak Street Suite B, Conway, AR 72032 | 2018-03-01 |
| 1750821625 | Luke Osborne | Physical Therapy Assistant | 1 Thomas Ln, Conway, AR 72032 | 2017-02-27 |
| 1639620099 | Sam's West, Inc. | Technician/Technologist | 1250 South Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1922559343 | Sam's West, Inc. | Durable Medical Equipment & Medical Supplies | 1250 Sourth Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1639629108 | Posture Store | Durable Medical Equipment & Medical Supplies | 3900 Dave Ward Dr., Suite 1900-130, Conway, AR 72032 | 2016-10-09 |
| Find all providers in zip 72032 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033726922 | Alicia Landry | Dietitian, Registered | 201 Donaghey Ave, Mcalister 100, Conway, AR 72035 | 2020-09-25 |
| 1083116941 | Whitney Marie Holland | Dietitian, Registered | 3475 Malvern Hill Rd, Conway, AR 72032-9163 | 2018-03-06 |
| 1104204270 | Erick Keith Mccarthy | Dietitian, Registered | 18 Water Oak Dr, Conway, AR 72034-3430 | 2015-05-11 |
| 1154627800 | Charity Ashworth | Dietitian, Registered | 700 Salem Rd, Conway, AR 72034-4818 | 2011-01-28 |
| 1760705222 | Alane Scheider | Dietitian, Registered | 500 Hiland Ave, Conway, PA 15027-1464 | 2010-03-11 |
| 1013240928 | Janet A Dance | Dietitian, Registered | 2125 Desha Dr, Conway, AR 72034-7394 | 2009-09-09 |
| 1528209558 | Nina L. Roofe | Dietitian, Registered | 12 Sarah Ln, Conway, AR 72032-9049 | 2009-03-21 |
| 1144244302 | Karen Nichole Thompson | Dietitian, Registered | 2125 College Avenue, Conway, AR 72034 | 2006-07-27 |
| 1366059560 | Lori Jean Dather | Dietitian, Registered | 603 Harkrider St, Conway, AR 72032-5633 | 2020-09-30 |
| 1851861892 | Haley Katherine Ruffin | Dietitian, Registered | 2302 College Ave, Conway, AR 72034-6297 | 2018-12-03 |
| Find all providers in CONWAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.