Individual provider Active NPI

Meghan Lea Shadick, M.S., CRC, LPC-IT

  • Case Manager/Care Coordinator
  • Bloomer, WI
National Provider Identifier
1285891895
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
18266 County Highway Q
Bloomer, WI 54724-3826
Phone
(715) 933-0297
NPI assigned
May 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary
Mental Health Counselor 101YM0800X WI
Counselor 101Y00000X

Addresses

Primary practice location

18266 County Highway Q
Bloomer, WI 54724-3826

Mailing address

18266 County Highway Q
Bloomer, WI 54724-3826
Phone (715) 933-0297

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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1285891895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18266 COUNTY HIGHWAY Q",
            "city": "BLOOMER",
            "state": "WI",
            "postal_code": "547243826",
            "telephone_number": "715-933-0297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18266 COUNTY HIGHWAY Q",
            "city": "BLOOMER",
            "state": "WI",
            "postal_code": "547243826",
            "telephone_number": "715-933-0297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADICK",
        "first_name": "MEGHAN",
        "middle_name": "LEA",
        "name_prefix": "Mrs.",
        "credential": "M.S., CRC, LPC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomer, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; 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.