Shandry L Peugeot, RN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

1-108205 Issued in AL

Practice address

3601 Cci Drive
Huntsville, AL 35805-2606

Phone

(256) 705-4224

Fax

(256) 705-4135

NPI assigned

Jul 31, 2009

Last updated

Dec 3, 2012By the provider in NPPES

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 identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

Practice roles

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.

• Oncology Specialties PC

  • Hematology & Oncology Physician
  • Huntsville, AL
  • NPI 1831380476
  NPD (past)

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1184855629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 18428",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358048428",
            "telephone_number": "256-705-4224",
            "fax_number": "256-705-4135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 CCI DRIVE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358052606",
            "telephone_number": "256-705-4224",
            "fax_number": "256-705-4135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEUGEOT",
        "first_name": "SHANDRY",
        "middle_name": "L",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-31",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AL",
            "license": "1-108205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP NO.",
            "identifier": "510-50070",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "E359",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gracie Deonne Pettus
• Joseph Atkins Pettus IV, M.D.
• Tina Marie Pettway, LPN
• April Petty, MED
• Stephen Allan Petty, D.O.
• Serena Pewitt, LPC
• Pharmacy First LLC (Pharmacy First)
• Ashley N Phelps, LICSW
• Phil's Pills Incorporated (The Medicine Shoppe Pharmacy)
• Philip a. Roth, Jr., MD/PC

• Adult Health Nurse Practitioner in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Adult Health Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; 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.