Active NPI
Shannell Renia Anderson
- Student in an Organized Health Care Education/Training Program
- Dorchester, MA
National Provider Identifier
1194363010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 50 Redfield St Ste 300
Dorchester, MA 02122-3653 - Phone
- (781) 540-4227
- NPI assigned
- Dec 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
50 Redfield St Ste 300
Dorchester, MA 02122-3653
Mailing address
131 Beverage Hill Ave Apt 3
Pawtucket, RI 02860-6232
Phone (240) 383-7336
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576022400000",
"number": "1194363010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 BEVERAGE HILL AVE APT 3",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028606232",
"telephone_number": "240-383-7336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 REDFIELD ST STE 300",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "021223653",
"telephone_number": "781-540-4227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "SHANNELL",
"middle_name": "RENIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-11",
"last_updated": "2019-12-11",
"certification_date": "2019-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dorchester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.