Lucy Shi, DO

Key facts

NPI

1013478049

Entity type

Individual (NPI type 1)

Primary specialty

General Practice Physician 208D00000X

License

0102206357 (VA)

Practice address

6905 Harris Ave
MCBH, HI 98734

Phone

(808) 257-3365

NPI assigned

Mar 31, 2019

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Osteopathy

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 19, 2023.

{
    "created_epoch": "1553990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1013478049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1683 GILBERT ST STE 100",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235110018",
            "telephone_number": "757-763-8640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6905 HARRIS AVE",
            "city": "MCBH",
            "state": "HI",
            "postal_code": "98734",
            "telephone_number": "808-257-3365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "480 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Pearl Harbor",
            "state": "HI",
            "postal_code": "968604908",
            "country_code": "US",
            "telephone_number": "808-257-3365",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Naval Medical Center San Diego 38400 Bob Wilson Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921345000",
            "country_code": "US",
            "telephone_number": "505-920-5838",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1683 Gilbert St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235110018",
            "country_code": "US",
            "telephone_number": "757-763-8640",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Camp Lemonnier",
            "address_purpose": "LOCATION",
            "city": "FPO",
            "state": "AE",
            "postal_code": "09363",
            "country_code": "US",
            "telephone_number": "757-763-8640",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "basic": {
        "last_name": "SHI",
        "first_name": "LUCY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-31",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0102206357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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