Active NPI
Shayla Jessup Yancey
- Specialist
- Elizabethtown, NC
National Provider Identifier
1043678634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 3363
- Practice address
- 207 C S Poplar St
Elizabethtown, NC 28337 - Phone
- (910) 874-8130
- NPI assigned
- Feb 10, 2016
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 3363 | NC | Primary |
Addresses
Primary practice location
207 C S Poplar St
Elizabethtown, NC 28337
Mailing address
PO Box 1446
Elizabethtown, NC 28337-1446
Phone (910) 874-8130
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3363 | NC | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dreamworks Therapeutic Learning Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Elizabethtown, NC
- NPI 1609236165
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455062400000",
"number": "1043678634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1446",
"city": "ELIZABETHTOWN",
"state": "NC",
"postal_code": "283371446",
"telephone_number": "910-874-8130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 C S POPLAR ST",
"city": "ELIZABETHTOWN",
"state": "NC",
"postal_code": "28337",
"telephone_number": "910-874-8130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YANCEY",
"first_name": "SHAYLA",
"middle_name": "JESSUP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-10",
"last_updated": "2016-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NC",
"license": "3363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabethtown, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.