Individual provider Active NPI

Shandria Daphene Seybold, FNP

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1003351594
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP132729 Issued in TX
Practice address
14855 Blanco Rd
Suite 400
San Antonio, TX 78216-7732
Phone
(210) 802-1133
Fax
(210) 493-2900
NPI assigned
Dec 20, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP132729 TX Primary

Addresses

Primary practice location

14855 Blanco Rd
Suite 400
San Antonio, TX 78216-7732

Mailing address

14855 Blanco Rd
Suite 400
San Antonio, TX 78216-7732
Phone (210) 802-1133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AP132729TXMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1482192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1003351594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14855 BLANCO RD",
            "address_2": "SUITE 400",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782167732",
            "telephone_number": "210-802-1133",
            "fax_number": "210-493-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14855 BLANCO RD",
            "address_2": "SUITE 400",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782167732",
            "telephone_number": "210-802-1133",
            "fax_number": "210-493-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEYBOLD",
        "first_name": "SHANDRIA",
        "middle_name": "DAPHENE",
        "name_prefix": "Prof.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-20",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP132729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.