Individual provider Active NPI

Shaques Quigless

  • Licensed Vocational Nurse
  • Victorville, CA
National Provider Identifier
1245655646
Registry record updated Feb 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
271890 Issued in CA
Practice address
12945 Walnut Way
Victorville, CA 92392-5569
Phone
(909) 346-8208
NPI assigned
Feb 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 271890 CA Primary

Addresses

Primary practice location

12945 Walnut Way
Victorville, CA 92392-5569

Mailing address

16161 Pamela St
Victorville, CA 92395-3632

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
271890CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1393027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393027200000",
    "number": "1245655646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16161 PAMELA ST",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12945 WALNUT WAY",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923925569",
            "telephone_number": "909-346-8208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIGLESS",
        "first_name": "SHAQUES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-22",
        "last_updated": "2014-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "271890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2014; 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.