Individual provider Active NPI

Shateonna McLemore

  • Case Manager/Care Coordinator
  • Flint, MI
National Provider Identifier
1164062931
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
6852092002 Issued in MI
Practice address
420 W 5TH Ave
Flint, MI 48503-2445
Phone
(810) 257-3705
NPI assigned
Jan 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Case Manager/Care Coordinator 171M00000X 6852092002 MI Primary

Addresses

Primary practice location

420 W 5TH Ave
Flint, MI 48503-2445

Mailing address

420 W 5TH Ave
Flint, MI 48503-2445

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6852092002MIMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1164062931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W 5TH AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W 5TH AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032445",
            "telephone_number": "810-257-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEMORE",
        "first_name": "SHATEONNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-09",
        "last_updated": "2022-04-27",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MI",
            "license": "6852092002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; 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.