Shawn Osborne, LICENSED PHLEBOTOMIS

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

License

L18000031175 Issued in FL

Practice address

1008 Disston Ave
Clermont, FL 34711-3704

Phone

(678) 790-6534

NPI assigned

Feb 10, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shawn Osborne Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1518220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518220800000",
    "number": "1225537756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 DISSTON AVE",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347113704",
            "telephone_number": "678-790-6534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 DISSTON AVE",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347113704",
            "telephone_number": "678-790-6534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "SHAWN",
        "name_prefix": "Mr.",
        "credential": "LICENSED PHLEBOTOMIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-10",
        "last_updated": "2018-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "FL",
            "license": "L18000031175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82-475854",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWN",
            "last_name": "OSBORNE",
            "credential": "LICENSED PHLEBOTOMIS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Phlebotomy Technician in Clermont, FL
• Providers in Clermont, FL by specialty
• Phlebotomy Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.