Faustina Josette Shore, RN MSN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RO45357 Issued in MD

Practice address

50 W Montgomery Ave Ste 300
Rockville, MD 20850-4244

Phone

(240) 686-5390

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Faustina Josette Czawlytko Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2025 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Master of Science - Nursing, Registered Nurse

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.

• Harmony Holistic LLC

  • Clinical Psychologist
  • Rockville, MD
  • NPI 1407321326
  NPD
• Venus & Mars Psychotherapy, L.L.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rockville, MD
  • NPI 1245853282
  NPD

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1154475945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 W MONTGOMERY AVE STE 300",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504244",
            "telephone_number": "240-686-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 W MONTGOMERY AVE STE 300",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504244",
            "telephone_number": "240-686-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "FAUSTINA",
        "middle_name": "JOSETTE",
        "name_prefix": "Ms.",
        "credential": "RN MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "RO45357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FAUSTINA",
            "last_name": "CZAWLYTKO",
            "middle_name": "JOSETTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Shook
• Mara Shook
• Rebecca Shorden
• Shore Health Services LLC
• Amanda Dory Shore, MS, CF-SLP
• Ronald Shore, M.D.
• Kaniahh Short
• Bertha Shorter
• Ikea Shorter
• La-Tisha Shorter

• All providers in Rockville, MD
• Registered Nurse in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.