Individual provider Active NPI

Chayoung Shoulders, DO

  • Student in an Organized Health Care Education/Training Program
  • Augusta, ME
National Provider Identifier
1124862420
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
TP24070 Issued in ME
Practice address
15 E Chestnut St
Augusta, ME 04330-5736
Phone
(207) 626-1561
Fax
(207) 626-1849
NPI assigned
Jun 21, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TP24070 ME Primary

Addresses

Primary practice location

15 E Chestnut St
Augusta, ME 04330-5736

Mailing address

15 E Chestnut St
Augusta, ME 04330-5736
Phone (207) 626-1561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240909003392 ME Order and Referring Only - Family PracticePractitioner - Family Practice 7911447610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
TP24070MEMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: chayoungshoulders@mgh.allscriptsdirect.net

NPI Registry JSON

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

{
    "created_epoch": "1718928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1124862420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 E CHESTNUT ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305736",
            "telephone_number": "207-626-1561",
            "fax_number": "207-626-1849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 E CHESTNUT ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305736",
            "telephone_number": "207-626-1561",
            "fax_number": "207-626-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOULDERS",
        "first_name": "CHAYOUNG",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-21",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "ME",
            "license": "TP24070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.