Individual provider Active NPI

Shishauna Summerson

  • Home Delivered Meals
  • Charlotte, NC
National Provider Identifier
1124935838
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Delivered MealsTaxonomy code 332U00000X
Practice address
4612 Gilead St Apt 412
Charlotte, NC 28217-3685
Phone
(980) 214-2399
NPI assigned
Aug 26, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Delivered Meals 332U00000X NC Primary

Addresses

Primary practice location

4612 Gilead St Apt 412
Charlotte, NC 28217-3685

Mailing address

4612 Gilead St Apt 412
Charlotte, NC 28217-3685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1787702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1124935838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4612 GILEAD ST APT 412",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282173685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4612 GILEAD ST APT 412",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282173685",
            "telephone_number": "980-214-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERSON",
        "first_name": "SHISHAUNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-26",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.