Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shannon Marie Roark, MS, RDN, CLC

Individual provider Registered Dietitian · NPI 1174722029

Shannon Marie Roark, MS, RDN, CLC is a Registered Dietitian in Johnson City, Tennessee. Licensed in Tennessee. Registered with an NPI since 2007.

Licensed in
TN
In the registry since
2007
What do these letters mean?
MS — Master of Science
A graduate science degree.
RDN — Registered Dietitian Nutritionist
The current title for a registered dietitian.

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Practice location Address checks out

185 Treasure Ln
Johnson City, TN 37604-7816
Phone: (423) 202-6404
Fax: (423) 979-3261
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 917714 (TN)

Record details

NPI number1174722029
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , RDN , CLC
Sole proprietorNo
NPI enumeratedJuly 12, 2007
Last updated in NPPESMarch 24, 2025
Certification dateMarch 24, 2025

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