Individual provider Active NPI

Shakoya M Fell, LPN

  • Licensed Practical Nurse
  • Woodside, NY
National Provider Identifier
1184977720
Registry record updated Oct 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
311149-1 Issued in NY
Practice address
5016 31St Ave Apt 5a
Woodside, NY 11377-1305
Phone
(347) 330-5404
NPI assigned
Oct 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 311149-1 NY Primary

Addresses

Primary practice location

5016 31St Ave Apt 5a
Woodside, NY 11377-1305

Mailing address

5016 31St Ave Apt 5a
Woodside, NY 11377-1305
Phone (347) 330-5404

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
311149-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350604800000",
    "number": "1184977720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5016 31ST AVE APT 5A",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113771305",
            "telephone_number": "347-330-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5016 31ST AVE APT 5A",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113771305",
            "telephone_number": "347-330-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELL",
        "first_name": "SHAKOYA",
        "middle_name": "M",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-19",
        "last_updated": "2012-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "311149-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.