Shatara Louise Vereen, CHW, CD, CHHC

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

CCHW.0100478 Issued in FL

Practice address

1111 NE 25TH Ave Ste 403
Ocala, FL 34470-5668

Phone

(352) 209-5126

NPI assigned

Feb 19, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Nurtured Moons LLC

  • Health & Wellness Coach
  • Ocala, FL
  • NPI 1053178855
  NPD Authorized official

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1114782018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8316 SW 136TH ST",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344736836",
            "telephone_number": "352-209-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 NE 25TH AVE STE 403",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344705668",
            "telephone_number": "352-209-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEREEN",
        "first_name": "SHATARA",
        "middle_name": "LOUISE",
        "credential": "CHW, CD, CHHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "FL",
            "license": "CCHW.0100478",
            "primary": true
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "FL",
            "license": "202311260",
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mairelys Venegas Rocha
• Venisure LLC
• Michelle Vento
• Sailaja V Ventrapragada, MD
• Raymond C Veras, MD
• Cathy Christine Vergara, ARNP
• Gustavo Vergara
• Isaac Samuel Vergara, M.D.
• Lisa Lim Vergara, PHARM.D.
• Josef J K Vesely, MD

• All providers in Ocala, FL
• Community Health Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; 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.