Shahidah Z Clanton, RN

Primary specialty

Ambulatory Care Registered NurseTaxonomy code 163WP2201X

License

714895-1 Issued in NY

Practice address

3711 Queens Blvd
Long Island City, NY 11101-1725

Phone

(718) 361-5100

Fax

(718) 361-5169

NPI assigned

Nov 30, 2011

Last updated

Oct 12, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1073880373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 QUEENS BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111011725",
            "telephone_number": "718-361-5100",
            "fax_number": "718-361-5169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 QUEENS BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111011725",
            "telephone_number": "718-361-5100",
            "fax_number": "718-361-5169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLANTON",
        "first_name": "SHAHIDAH",
        "middle_name": "Z",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-30",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "NY",
            "license": "714895-1",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "295432-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City Dermatology PC
• City Kids Psychological Services, PLLC
• City Medical of Upper East Side, PLLC (CityMD)
• City of Ny Office of Payroll Adm C/O Office of Payroll Admin (nyc dept. of health and mental hygiene)
• City of Ny Office of Payroll Adm C/O Office of Payroll Admin (nyc dept. of health and mental hygiene)
• Karen Clark, LCSW-R
• Jennifer Clarke-Reid, RN
• Camille Danica Claudio, RN
• Maria Claudio, LMSW
• Kristine Claveria, COTA

• Ambulatory Care Registered Nurse in Long Island City, NY
• Providers in Long Island City, NY by specialty
• Ambulatory Care Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.

Verify at the official NPI Registry.