Individual provider Active NPI

Shanlyn Marie Newman, DC

  • Chiropractor
  • Mesa, AZ
National Provider Identifier
1043218969
Registry record updated May 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4686 Issued in AZ
Practice address
266 W 3Rd PL
Suite 1
Mesa, AZ 85201-6578
Phone
(480) 835-1174
Fax
(480) 835-1130
NPI assigned
Jul 13, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4686 AZ Primary

Addresses

Primary practice location

266 W 3Rd PL
Suite 1
Mesa, AZ 85201-6578

Mailing address

266 W 3Rd PL
Suite 1
Mesa, AZ 85201-6578
Phone (480) 835-1174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051209000215 AZ Practitioner - Chiropractic 1951322668 Practice locations: Mesa, AZ

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1989
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

266 W 3Rd PL
Suite 1
Mesa, AZ 85201-6578
Phone (480) 835-1174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4686AZMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335916800000",
    "number": "1043218969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "266 W 3RD PL",
            "address_2": "SUITE 1",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852016578",
            "telephone_number": "480-835-1174",
            "fax_number": "480-835-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 W 3RD PL",
            "address_2": "SUITE 1",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852016578",
            "telephone_number": "480-835-1174",
            "fax_number": "480-835-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWMAN",
        "first_name": "SHANLYN",
        "middle_name": "MARIE",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-13",
        "last_updated": "2012-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "4686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.