Shinemed Primary Care PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

SHINEMED PRIMARY CARE PLLC

Practice address

440 Cobia Dr Ste 101
Katy, TX 77494-6891

Phone

(346) 338-9360

Fax

(346) 338-9370

NPI assigned

Jun 14, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Eunyoung Lee, DNP, APRN, FNP-CNPI 1699262337

Title

Family Nurse Practitioner /Owner

Phone

(346) 338-9360

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eunyoung Lee

  • Family Nurse Practitioner
  • Katy, TX
  • NPI 1699262337
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703462400000",
    "number": "1306576087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 COBIA DR STE 101",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774946891",
            "telephone_number": "346-338-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 COBIA DR STE 101",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774946891",
            "telephone_number": "346-338-9360",
            "fax_number": "346-338-9370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINEMED PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-14",
        "last_updated": "2023-12-25",
        "certification_date": "2023-12-25",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "EUNYOUNG",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER /OWNER",
        "authorized_official_telephone_number": "346-338-9360",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, APRN, FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kristen Elizabeth Shives, RDN, LD
• Ryan Shockency, MS, BCBA
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• Sydney Shoemaker, COTA
• Divine Shomongo, RN

• Family Nurse Practitioner in Katy, TX
• Providers in Katy, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.