Active NPI
Hayley Ann Shackleford, MD
- Student in an Organized Health Care Education/Training Program
- Sioux Falls, SD
National Provider Identifier
1114593340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1400 W 22ND St
Sioux Falls, SD 57105-1554 - Phone
- (605) 333-7197
- NPI assigned
- May 28, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1400 W 22ND St
Sioux Falls, SD 57105-1554
Mailing address
60 W 8TH Ave Apt C2
Columbus, OH 43201-8303
Phone (571) 426-9312
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211004002998 | SD | Order and Referring Only - Pediatric Medicine | 8224436340 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0641 | SD | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622160000000",
"number": "1114593340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 W 8TH AVE APT C2",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432018303",
"telephone_number": "571-426-9312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 W 22ND ST",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571051554",
"telephone_number": "605-333-7197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHACKLEFORD",
"first_name": "HAYLEY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-28",
"last_updated": "2021-05-28",
"certification_date": "2021-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.