Active NPI
Shuriah Wallace
- Home Health Agency
- Bel Air, MD
National Provider Identifier
1083357032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Practice address
- 602 Emmy Dee Dr
Bel Air, MD 21014-1822 - Phone
- (443) 567-8214
- NPI assigned
- Apr 18, 2022
- 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 |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
602 Emmy Dee Dr
Bel Air, MD 21014-1822
Mailing address
602 Emmy Dee Dr
Bel Air, MD 21014-1822
Phone (443) 567-8214
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": "1650240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650240000000",
"number": "1083357032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "602 EMMY DEE DR",
"city": "BEL AIR",
"state": "MD",
"postal_code": "210141822",
"telephone_number": "443-567-8214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "602 EMMY DEE DR",
"city": "BEL AIR",
"state": "MD",
"postal_code": "210141822",
"telephone_number": "443-567-8214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "SHURIAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-18",
"last_updated": "2022-04-18",
"certification_date": "2022-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bel Air, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.