Shannon Hertzog, BS, MS
NPI 1124602560 · Registered Dietitian · Longview, WA
Enrolled with Medicare as Practitioner - Registered Dietitian Or Nutrition Professional · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Shannon Hertzog, BS, MS is a Registered Dietitian provider in Longview, WA (NPI 1124602560).
Provider details
- NPI number
- 1124602560
- Entity type
- Individual
- Primary specialty
- Registered DietitianDietary & Nutritional Service Providers
- Credential
- BS, MS
- Sex
- Female
- Sole proprietor
- No
- License
- DI61176521 (WA)
Specialties & taxonomies
Dietary & Nutritional Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 2005 W Main St Ste 130Battle Ground, WA 98604-4311Phone: (360) 882-2778Fax: (360) 604-1785
Registry dates
- Enumerated
- 2021-05-11
- Last updated
- 2025-12-20
- Certified
- 2025-12-20
Frequently asked questions
- What is Shannon Hertzog's NPI number?
- Shannon Hertzog's National Provider Identifier (NPI) is 1124602560, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Shannon Hertzog's specialty?
- Shannon Hertzog is listed in the NPPES registry with a primary specialty of Registered Dietitian (Dietary & Nutritional Service Providers).
- Where is Shannon Hertzog located?
- Shannon Hertzog's practice location on file with NPPES is 1615 Delaware St, Longview, WA 98632-2367.
- What is Shannon Hertzog's phone number?
- The practice phone number listed in the NPPES registry for Shannon Hertzog is (360) 501-3601.
- Does Shannon Hertzog accept Medicare?
- Shannon Hertzog is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Shannon Hertzog's NPI active?
- Yes — Shannon Hertzog's NPI (1124602560) is active in the NPPES registry as of the last update on 2025-12-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.