Individual provider Active NPI

Shaneaka Parker, RN

  • Registered Nurse
  • Rochester, NY
National Provider Identifier
1114294881
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
690720 Issued in NY
Practice address
352 Avery St
Rochester, NY 14606-2659
Phone
(585) 270-5311
NPI assigned
Nov 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 690720 NY Primary

Addresses

Primary practice location

352 Avery St
Rochester, NY 14606-2659

Mailing address

352 Avery St
Rochester, NY 14621-5613
Phone (585) 270-5311

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
690720NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1322179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1114294881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 AVERY ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146215613",
            "telephone_number": "585-270-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 AVERY ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146062659",
            "telephone_number": "585-270-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "SHANEAKA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-25",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "690720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.