Active NPI
Shedrick Anderson
- Driver
- Palm Coast, FL
National Provider Identifier
1063288355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- Practice address
- 9 Old Kings Rd N Ste 1231001
Palm Coast, FL 32137-4603 - Phone
- (386) 864-0144
- NPI assigned
- Nov 28, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Driver | 172A00000X | FL | Primary |
Addresses
Primary practice location
9 Old Kings Rd N Ste 1231001
Palm Coast, FL 32137-4603
Mailing address
9 Old Kings Rd N Ste 1231001
Palm Coast, FL 32137-4603
Phone (386) 864-0144
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701129600000",
"number": "1063288355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 OLD KINGS RD N STE 1231001",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321374603",
"telephone_number": "386-864-0144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 OLD KINGS RD N STE 1231001",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321374603",
"telephone_number": "386-864-0144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "SHEDRICK",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-11-28",
"last_updated": "2023-11-28",
"certification_date": "2023-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Coast, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.