MEDICARE: ASHLEY T SHAGRIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	ND14843	FL
2	133V00000X	Registered Dietitian	LPD.11081	OH

General Provider Information

NPI Number	:	1952269763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY T SHAGRIN

Provider Business Mailing Address
First Line	:	875 W 1ST AVE UNIT 617
Second Line	:
City	:	GRANDVIEW HEIGHTS
State	:	OH
Zip	:	43212-1690
Country	:	US
Telephone Number	:	216-973-2572
Fax Number	:

Provider Business Practice Location Address
First Line	:	875 W 1ST AVE UNIT 617
Second Line	:
City	:	GRANDVIEW HEIGHTS
State	:	OH
Zip	:	43212-1690
Country	:	US
Telephone Number	:	216-973-2572
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “ ASHLEY T SHAGRIN ” Practice Location

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