Active NPI
Shanetra Fowler
- Clinical Social Worker
- Lockhart, TX
National Provider Identifier
1215499785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 63901
- Practice address
- 896 Robin Ranch Rd
Lockhart, TX 78644-4578 - Phone
- (512) 376-2101
- Fax
- (512) 398-3040
- NPI assigned
- Apr 3, 2019
- Last updated
- Apr 3, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 63901 | TX | Primary |
Addresses
Primary practice location
896 Robin Ranch Rd
Lockhart, TX 78644-4578
Mailing address
896 Robin Ranch Rd
Lockhart, TX 78644-4578
Phone (512) 376-2101
Other names 1
- Shanetra Miles
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63901 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
| RS&D Counseling and Consulting, PLLC | Current | Accepting new patients | |
| Hospital Internists of Texas, LLC | Past | Accepting new patients |
Interoperability endpoints
- shanetrafowler@tdh.allscriptsdirect.net
Organizations & group practices 3
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.
-
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- Austin, TX
- NPI 1790452852
-
- Internal Medicine Physician
- Austin, TX
- NPI 1912430281
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554249600000",
"number": "1215499785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "896 ROBIN RANCH RD",
"city": "LOCKHART",
"state": "TX",
"postal_code": "786444578",
"telephone_number": "512-376-2101",
"fax_number": "512-398-3040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "896 ROBIN RANCH RD",
"city": "LOCKHART",
"state": "TX",
"postal_code": "786444578",
"telephone_number": "512-376-2101",
"fax_number": "512-398-3040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOWLER",
"first_name": "SHANETRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-03",
"last_updated": "2019-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "63901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHANETRA",
"last_name": "MILES",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lockhart, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.