Shane Michael Lambert
Individual provider Active NPI Personal Care Attendant · Pine Grove, WV
NPI 1053140459 · NPPES record last updated Aug 1, 2024
Key facts
- NPI
- 1053140459
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 107 Valley Manor LN
Pine Grove, WV 26419-8252 - Phone
- (304) 815-1844
- NPI assigned
- Aug 1, 2024
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Yes |
Addresses
Primary practice location
107 Valley Manor LN
Pine Grove, WV 26419-8252
Mailing address
107 Valley Manor LN
Pine Grove, WV 26419-8252
Phone (304) 815-1844
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356607394 | Medicaid | WV | |
| 1821206228 | Medicaid | WV | |
| 125553494 | Medicaid | WV |
Other providers in Pine Grove, WV
- Angela D Adams
- Penny Jane Baker
- Sharon Lee Gump
- Cindy Howell
- Renee Nicole McDougal
- Tracy Pearl Myers
- Norris Pharmacy Inc
- Pharmacole Inc
- Kathy Sue Rosa
All providers in Pine Grove, WV · Personal Care Attendant in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.