Active NPI
Casey Shockley
- Student in an Organized Health Care Education/Training Program
- Long Beach, CA
National Provider Identifier
1013240787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1975 Long Beach Blvd.
Long Beach, CA 90806 - Phone
- (562) 218-4013
- Fax
- (562) 599-3934
- NPI assigned
- Sep 14, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1975 Long Beach Blvd.
Long Beach, CA 90806
Mailing address
1975 Long Beach Blvd.
Long Beach, CA 90806
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W-2983H | Other | CA | MEDICARE PROVIDER NUMBER |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252886400000",
"number": "1013240787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1975 LONG BEACH BLVD.",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1975 LONG BEACH BLVD.",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90806",
"telephone_number": "562-218-4013",
"fax_number": "562-599-3934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOCKLEY",
"first_name": "CASEY",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-14",
"last_updated": "2009-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PROVIDER NUMBER",
"identifier": "W-2983H",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.