Active NPI
Eterial Shondrell Burrell, R.N., W.H.N.P.- B.C.
- Nurse Practitioner
- Nashville, TN
National Provider Identifier
1215350665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN656187
- Practice address
- 2500 Charlotte Ave
Nashville, TN 37209-4129 - Phone
- (615) 340-5616
- NPI assigned
- Jan 21, 2014
- Last updated
- Apr 20, 2016
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN656187 | PA | Primary |
Addresses
Primary practice location
2500 Charlotte Ave
Nashville, TN 37209-4129
Mailing address
2500 Charlotte Ave
Nashville, TN 37209-4129
Phone (615) 340-5616
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)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN656187 | PA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Res Ventures, LLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1390262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461110400000",
"number": "1215350665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 CHARLOTTE AVE",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372094129",
"telephone_number": "615-340-5616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 CHARLOTTE AVE",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372094129",
"telephone_number": "615-340-5616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURRELL",
"first_name": "ETERIAL",
"middle_name": "SHONDRELL",
"credential": "R.N., W.H.N.P.- B.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-21",
"last_updated": "2016-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "PA",
"license": "RN656187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nashville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.