Active NPI
Shanakay Haughton
- Family Health Clinical Nurse Specialist
- Timonium, MD
National Provider Identifier
1316315187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Health Clinical Nurse Specialist
- License
- R196752
- Practice address
- 9515 Deereco Rd
Suite 205
Timonium, MD 21093-2116 - Phone
- (410) 252-6836
- NPI assigned
- Sep 9, 2015
- Last updated
- Feb 1, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Health Clinical Nurse Specialist | 364SF0001X | R196752 | MD | Primary |
Addresses
Primary practice location
9515 Deereco Rd
Suite 205
Timonium, MD 21093-2116
Mailing address
2001 Butterfield Rd
Suite 330
Downers Grove, IL 60515-1050
Phone (630) 725-2700
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R196752 | MD | MD | Family Health Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485907200000",
"number": "1316315187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2001 BUTTERFIELD RD",
"address_2": "SUITE 330",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605151050",
"telephone_number": "630-725-2700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9515 DEERECO RD",
"address_2": "SUITE 205",
"city": "TIMONIUM",
"state": "MD",
"postal_code": "210932116",
"telephone_number": "410-252-6836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAUGHTON",
"first_name": "SHANAKAY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-09",
"last_updated": "2017-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "364SF0001X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Family Health",
"state": "MD",
"license": "R196752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Timonium, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.