Shasta Dockery, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R104622 Issued in AR

Practice address

15020 Wade Blvd.
North Little Rock, AR 72113

Phone

(501) 231-9732

NPI assigned

Jul 3, 2017

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 names 1

• Shasta Davis Former name

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": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104347814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15020 WADE BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721136876",
            "telephone_number": "501-231-9732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15020 WADE BLVD.",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "72113",
            "telephone_number": "501-231-9732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCKERY",
        "first_name": "SHASTA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R104622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHASTA",
            "last_name": "DAVIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Janette Lashay Dixon
• Keith Alan Dixon, MD
• Jennifer Stratton DO, MD
• Robin Carol Dobbs, APN
• Logan Dockery, PT, DPT, PHD
• Taylor Dodd
• Sabrina Doffing
• Allison Elizabeth Dolan
• Jessica Domino, PH.D.
• Breesha Donahue, LCSW

• Registered Nurse in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Registered Nurse in Arkansas

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

Verify at the official NPI Registry.