Individual provider Active NPI

Shaquirah Lashea Screen

  • Religious Nonmedical Nursing Personnel
  • Bainbridge, GA
National Provider Identifier
1306439328
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Religious Nonmedical Nursing PersonnelTaxonomy code 374T00000X
Practice address
925 S West St # Atb
Bainbridge, GA 39819-4519
Phone
(229) 205-5032
NPI assigned
Feb 20, 2021
Last updated
Apr 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Religious Nonmedical Nursing Personnel 374T00000X NU Primary

Addresses

Primary practice location

925 S West St # Atb
Bainbridge, GA 39819-4519

Mailing address

925 S West St Apt B
Bainbridge, GA 39819-4530
Phone (229) 205-5032

Other identifiers 2

IdentifierTypeStateIssuer
049851617OtherGADL
059851617OtherGAID

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

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Chronic Care Management LLC Current Accepting new patients
Southern Serenity Home Care CurrentSince Sep 4, 2022 Accepting new patients
Southern Serenity Wellness Current Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1613779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1306439328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 S WEST ST APT B",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194530",
            "telephone_number": "229-205-5032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 S WEST ST # ATB",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194519",
            "telephone_number": "229-205-5032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCREEN",
        "first_name": "SHAQUIRAH",
        "middle_name": "LASHEA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-20",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374T00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Nursing Personnel",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DL",
            "identifier": "049851617",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ID",
            "identifier": "059851617",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.