Shane Jerome Seery, I.D.C.

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

Building 632044 Christianitos Road
Naval Expeditionary Medical Training Institute
Camp Pendleton, CA 92055

Phone

(760) 725-7121

NPI assigned

Sep 3, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399334400000",
    "number": "1063645208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PSC BOX 555223",
            "address_2": "NAVAL EXPEDITIONARY MEDICAL TRAINING INSTITUTE",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555223",
            "telephone_number": "760-725-7121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BUILDING 632044 CHRISTIANITOS ROAD",
            "address_2": "NAVAL EXPEDITIONARY MEDICAL TRAINING INSTITUTE",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "760-725-7121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEERY",
        "first_name": "SHANE",
        "middle_name": "JEROME",
        "name_prefix": "Mr.",
        "credential": "I.D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-03",
        "last_updated": "2014-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Charles Schexnayder, M.D.
• Jeffrey Olen Schneider, D.C.
• Ella Hahn Schultz, DO
• Jacob Daniel Schultz, MD
• Trevor Raymond Scott, DPT
• Mason L Segura, DDS
• Matthew Serafine, DO
• Megan Serratore, MD
• Daniel Louis Severance
• Timothy Daniel Severino, SOIDC

• Independent Duty Corpsman in Camp Pendleton, CA
• Providers in Camp Pendleton, CA by specialty
• Independent Duty Corpsman in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.