Individual provider Active NPI

Shakeva Brown Nnaji, PHELEBTOMIST

  • Medical Laboratory Technician
  • Bronx, NY
National Provider Identifier
1174122865
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Laboratory TechnicianTaxonomy code 246RM2200X
Practice address
1469 Hammersley Ave
Bronx, NY 10469-3024
Phone
(914) 563-7372
NPI assigned
Oct 22, 2020
Last updated
May 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Laboratory Technician 246RM2200X NY Primary

Addresses

Primary practice location

1469 Hammersley Ave
Bronx, NY 10469-3024

Mailing address

1469 Hammersley Ave
Bronx, NY 10469-3024
Phone (914) 563-7372

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL BRONX Direct

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Mobile Diagnostics LLC CurrentSince Nov 29, 2020 Accepting new patients
Senior Serenity Home Care Current Accepting new patients
Serenity Diagnostic Current Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1174122865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1469 HAMMERSLEY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104693024",
            "telephone_number": "914-563-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1469 HAMMERSLEY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104693024",
            "telephone_number": "914-563-7372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN NNAJI",
        "first_name": "SHAKEVA",
        "credential": "PHELEBTOMIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RM2200X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Medical Laboratory",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "BRONX",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "1469 Hammersley Ave",
            "city": "Bronx",
            "state": "NY",
            "country_code": "US",
            "postal_code": "104693024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.