Active NPI
Shawna Nicholas, LPN
- Case Manager/Care Coordinator
- Walnut Ridge, AR
National Provider Identifier
1023349032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 1425 W Main St
Walnut Ridge, AR 72476-1431 - Phone
- (870) 886-5303
- Fax
- (870) 886-7002
- NPI assigned
- Jan 15, 2010
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
1425 W Main St
Walnut Ridge, AR 72476-1431
Mailing address
4508 Stadium Blvd
Jonesboro, AR 72404-9675
Phone (870) 933-6886
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": "1263513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263513600000",
"number": "1023349032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4508 STADIUM BLVD",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724049675",
"telephone_number": "870-933-6886",
"fax_number": "870-933-9395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 W MAIN ST",
"city": "WALNUT RIDGE",
"state": "AR",
"postal_code": "724761431",
"telephone_number": "870-886-5303",
"fax_number": "870-886-7002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLAS",
"first_name": "SHAWNA",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-15",
"last_updated": "2010-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Walnut Ridge, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.