Active NPI
Shawnnell Jernee Pugh, LCSW
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1013156967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 63759
- Practice address
- 550 S. Vermont Ave
Los Angeles, CA 90020 - Phone
- (213) 944-3712
- NPI assigned
- Feb 17, 2009
- Last updated
- Jun 2, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 63759 | CA | Primary |
Addresses
Primary practice location
550 S. Vermont Ave
Los Angeles, CA 90020
Mailing address
550 S Vermont Ave FL 3
Los Angeles, CA 90020-1912
Phone (213) 944-3712
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
| License | State | Type | Specialty |
|---|---|---|---|
| 63759 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
Interoperability endpoints
- shawnnellpugh@tdh.allscriptsdirect.net
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433203200000",
"number": "1013156967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 S VERMONT AVE FL 3",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900201912",
"telephone_number": "213-944-3712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 S. VERMONT AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90020",
"telephone_number": "213-944-3712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUGH",
"first_name": "SHAWNNELL",
"middle_name": "JERNEE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-17",
"last_updated": "2015-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "63759",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.