Individual provider Active NPI

Shannon M Yamashiro, LPN

  • Licensed Practical Nurse
  • Avondale, AZ
National Provider Identifier
1104332535
Registry record updated Dec 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
320516 Issued in WI
Practice address
3300 N Santa Fe TRL
Avondale, AZ 85392-6734
Phone
(661) 860-7026
NPI assigned
Dec 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 320516 WI Primary

Addresses

Primary practice location

3300 N Santa Fe TRL
Avondale, AZ 85392-6734

Mailing address

3300 N Santa Fe TRL
Avondale, AZ 85392-6734
Phone (661) 860-7026

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

State licenses

LicenseStateTypeSpecialty
320516WIMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Corte Sierra Elementary School Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513814400000",
    "number": "1104332535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 N SANTA FE TRL",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853926734",
            "telephone_number": "661-860-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 N SANTA FE TRL",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853926734",
            "telephone_number": "661-860-7026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMASHIRO",
        "first_name": "SHANNON",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-21",
        "last_updated": "2017-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "320516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2017; 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.