Individual provider Active NPI

Shahana N Garner, L.C.S.W.

  • Clinical Social Worker
  • Gloucester, VA
National Provider Identifier
1205890860
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904005579 Issued in VA
Practice address
9228 George Washington Memorial Hwy
Gloucester, VA 23061-4162
Phone
(804) 693-5068
Fax
(804) 693-7407
NPI assigned
Apr 12, 2006
Last updated
Feb 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904005579 VA Primary

Addresses

Primary practice location

9228 George Washington Memorial Hwy
Gloucester, VA 23061-4162

Mailing address

9228 George Washington Memorial Hwy
Gloucester, VA 23061-4162
Phone (804) 693-5068

Other identifiers 7

IdentifierTypeStateIssuer
386618OtherVAANTHEM
386618OtherVAHEALTHKEEPERS
386618MedicaidVA
O87096MMedicaidVA
O87096MOtherVASOUTHERN HEALTH
331732OtherVATRICARE
004945115MedicaidVA

Other names 1

  • Shahana Keisler Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100820000033 VA Practitioner - Clinical Social Worker 8224162664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9228 George Washington Memorial Hwy
Gloucester, VA 23061-4162
Phone (804) 693-5057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Middle Peninsula Northern Neck Mental Health & Retardation CurrentSince Nov 18, 2015 Accepting new patients
Middle Peninsula-Northern Neck Mental Health and Mental Retardation CurrentSince Nov 18, 2015 Accepting new patients

Locations

9228 George Washington Memorial Hwy
Gloucester, VA 23061
Phone (804) 693-5057

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, 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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1205890860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9228 GEORGE WASHINGTON MEMORIAL HWY",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614162",
            "telephone_number": "804-693-5068",
            "fax_number": "804-693-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9228 GEORGE WASHINGTON MEMORIAL HWY",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614162",
            "telephone_number": "804-693-5068",
            "fax_number": "804-693-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARNER",
        "first_name": "SHAHANA",
        "middle_name": "N",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904005579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "386618",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHKEEPERS",
            "identifier": "386618",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "386618",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "O87096M",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "O87096M",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "331732",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945115",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAHANA",
            "last_name": "KEISLER",
            "credential": "L.C.S.W.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gloucester, VA

Sources for this page

Verify at the official NPI Registry.