| Lisa Raynelle Shelley, RD, LD, CDE, BC-ADM | |
|
2460 Curtis Ellis Dr, Rocky Mount, NC 27804 | |
| (806) 212-0577 | |
| (806) 212-0563 |
| Full Name | Lisa Raynelle Shelley |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 2460 Curtis Ellis Dr, Rocky Mount, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659529378 | NPI | - | NPPES |
| 20120483 | Other | NCBDE | |
| 942472 | Other | TX | AMERICAN DIETETIC ASSOCIATION |
| 200913419 | Other | AMERICAN ASSOCIATION OF DIABETIC EDUCATORS | |
| DT80908 | Other | TX | TEXAS STATE BOARD OF EXAMINERS OF DIETITIANS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | DT80908 (Texas) | Secondary |
| 133V00000X | Dietitian, Registered | L005339 (North Carolina) | Primary |
| Provider Name | Nhcs Physicians Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1215336870 PECOS PAC ID: 7719209154 Enrollment ID: O20141215000093 |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Raynelle Shelley, RD, LD, CDE, BC-ADM Po Box 847556, Dallas, TX 75284-7556 Ph: (806) 212-0577 | Lisa Raynelle Shelley, RD, LD, CDE, BC-ADM 2460 Curtis Ellis Dr, Rocky Mount, NC 27804 Ph: (806) 212-0577 |
Ms. Susan Jane White, RD, CDE Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1041 Noell Ln, St 101, Rocky Mount, NC 27804 Phone: 252-446-6964 Fax: 252-442-4531 | |
Denise A Dunn-cerja, Dietitian Medicare: Medicare Enrolled Practice Location: 2460 Curtis Ellis Dr, Rocky Mount, NC 27804 Phone: 252-962-6675 | |
Crossworks Inc Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1041 Noell Ln, Rocky Mount, NC 27804 Phone: 252-446-6964 Fax: 252-442-4531 | |
Ms. Frances Ann Duff, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2460 Curtis Ellis Dr, Rocky Mount, NC 27804 Phone: 252-962-8368 | |
Jama C Whitehurst, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 901 N Winstead Ave, Rocky Mount, NC 27804 Phone: 252-937-0200 Fax: 252-937-0445 | |
Jason M O'briant, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 901 N Winstead Ave, Rocky Mount, NC 27804 Phone: 252-937-0200 Fax: 252-937-2903 | |
Ms. Debra Gail Long, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1041 Noell Ln, Rocky Mount, NC 27804 Phone: 252-903-5683 |