Shanda Vinson, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A003867 Issued in AR

Practice address

1515 W 42ND Ave
Pine Bluff, AR 71603-7004

Phone

(870) 541-6400

NPI assigned

Apr 10, 2014

Sex

Female

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

Credentials

Nurse Practitioner

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.

• Arkansas Children'S Medical Group PLLC

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1396274841
  NPD (past)
• Arkansas Childrens Hospital

  • Dental Clinic/Center
  • Little Rock, AR
  • NPI 1770889552
  NPD (past)

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397088000000",
    "number": "1104245745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 GOGGANS RD",
            "city": "RISON",
            "state": "AR",
            "postal_code": "716658224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 W 42ND AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037004",
            "telephone_number": "870-541-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINSON",
        "first_name": "SHANDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-10",
        "last_updated": "2014-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A003867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Arvin Vegafria Urbano, RPT
• Urology Associates of South Arkansas
• Chizoba Usuwa, MD
• V. Bryan Perry MD PA
• Jon C Valentine, CRNA
• Jewell D Vocque, CRNA
• W. Brent Hall, O.D. P.a.
• W.Jim Moore, Jr. D.D.S.,LTD.
• Bernadine Waddell, RN
• Imran Waheed, M.D.

• Family Nurse Practitioner in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.