Individual provider Active NPI

Shea Nicole Parker, PA-C

  • Medical Physician Assistant
  • Houston, TX
National Provider Identifier
1205132834
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA10688 Issued in TX
Practice address
14201 E Sam Houston Pkwy N
Houston, TX 77044
Phone
(281) 436-8999
NPI assigned
Jan 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA10688 TX Primary

Addresses

Primary practice location

14201 E Sam Houston Pkwy N
Houston, TX 77044

Mailing address

308 Willard St
Houston, TX 77006-2144

Other practice location 1

535 E 70th St
New York, NY 10021-4823
Phone (212) 606-1000

Other practice location 2

921 Gessner Rd
Houston, TX 77024-2501
Phone (713) 242-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170201001663 TX Practitioner - Physician Assistant 1557516853 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA10688TXMDMedical Physician Assistant

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1296259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1205132834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 WILLARD ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770062144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14201 E SAM HOUSTON PKWY N",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77044",
            "telephone_number": "281-436-8999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 E 70th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100214823",
            "country_code": "US",
            "telephone_number": "212-606-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "921 Gessner Rd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770242501",
            "country_code": "US",
            "telephone_number": "713-242-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKER",
        "first_name": "SHEA",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-29",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA10688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.