Active NPI
Shaederrica Theus
- Nurse's Aide
- Fort Worth, TX
National Provider Identifier
1053814053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- Practice address
- 8640 Cove Meadow LN
Ft Worth, TX 76123-2330 - Phone
- (318) 762-1281
- NPI assigned
- Mar 15, 2018
- Last updated
- Mar 15, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | TX | Primary |
Addresses
Primary practice location
8640 Cove Meadow LN
Ft Worth, TX 76123-2330
Mailing address
5311 Wendel Dr
Ft Worth, TX 76133-4813
Phone (318) 762-1281
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 081112616 | Other | TX | DBA |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| My Saints | Current | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Home Health Agency
- Fort Worth, TX
- NPI 1023511029
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521072000000",
"number": "1053814053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5311 WENDEL DR",
"city": "FT WORTH",
"state": "TX",
"postal_code": "761334813",
"telephone_number": "318-762-1281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8640 COVE MEADOW LN",
"city": "FT WORTH",
"state": "TX",
"postal_code": "761232330",
"telephone_number": "318-762-1281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEUS",
"first_name": "SHAEDERRICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-15",
"last_updated": "2018-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "TX",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DBA",
"identifier": "081112616",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
- Therapy Street PLLC
- Therapywell
- Theresa Kellam, PH.D.
- Rachel Leigh Theriault, M.D.
- Mary Theuer, LPC
- Thi of Texas at Fort Worth, LLC (The Courtyards at Fort Worth)
- Thi of Texas at Forth Worth LLC (The Courtyards at Fort Worth)
- Tran Thi, PA
- Chandler N Thibodaux, P.A
- Verne Anthony Thibodeaux Jr., PHARM.D
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.