Individual provider Active NPI

Shenise Seabrook, FNP

  • Family Nurse Practitioner
  • Manassas, VA
National Provider Identifier
1033526231
Registry record updated Dec 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024176690 Issued in VA
Practice address
6909 Stethem CT
Manassas, VA 20112-3080
Phone
(843) 452-9746
NPI assigned
Jul 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024176690 VA Primary
Family Nurse Practitioner 363LF0000X 18891 SC

Addresses

Primary practice location

6909 Stethem CT
Manassas, VA 20112-3080

Mailing address

6909 Stethem CT
Manassas, VA 20112-3080
Phone (843) 452-9746

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024176690VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Watch, LLC Family CurrentSince Dec 18, 2022 Accepting new patients
Gray'S Pain Relief Center, LLC PastSince Sep 15, 2014 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1405814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671235200000",
    "number": "1033526231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6909 STETHEM CT",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201123080",
            "telephone_number": "843-452-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6909 STETHEM CT",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201123080",
            "telephone_number": "843-452-9746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEABROOK",
        "first_name": "SHENISE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-20",
        "last_updated": "2022-12-17",
        "certification_date": "2022-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024176690",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "18891",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2022; 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.