Shavonna Beals

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

1306384219 Issued in NV

Practice address

1517 Santa Rosalia Dr
North Las Vegas, NV 89031-1010

Phone

(702) 929-3297

NPI assigned

Dec 4, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Productive Community Services

  • Developmentally Disabled Services Day Training Agency
  • Las Vegas, NV
  • NPI 1588222871
  NPD (past)
• Productive Homecare Service LLC

  • In Home Supportive Care Agency
  • North Las Vegas, NV
  • NPI 1306384219
  NPD (past)

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1093310179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 SANTA ROSALIA DR",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890311010",
            "telephone_number": "702-929-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 SANTA ROSALIA DR",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890311010",
            "telephone_number": "702-929-3297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEALS",
        "first_name": "SHAVONNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-04",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NV",
            "license": "1306384219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306384219",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Curtis Eugene Bazemore Jr., M.D.
• Vernita Catherine Beach, LMSW, CSW-I
• Michelle L Beachler
• Beacon of Hope Wellness Center, LLC
• Milagros Boduan Beals
• Javon Beard
• Tiffany Beard
• Beautiful Minds Behavioral Health Facility LLC
• Beautiful Minds Mental Health and Primary Care Clinic
• Beautiful Minds Primary Care Clinic LLC

• All providers in North Las Vegas, NV
• Home Health Aide in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; 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.