Chao Shen

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4006618 Issued in KY

Practice address

2480 Llewellyn Ave
Fort George G Meade, MD 20755-5129

Phone

(301) 677-8196

NPI assigned

Nov 10, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1336741750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5663 ZOE LN",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217047554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 LLEWELLYN AVE",
            "city": "FORT GEORGE G MEADE",
            "state": "MD",
            "postal_code": "207555129",
            "telephone_number": "301-677-8196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEN",
        "first_name": "CHAO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-10",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1116428",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4006618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamar Elise Sautter, MD
• Allison Schmider
• Allison Loretta Seale, M.D.
• Tony Serrano-Padin, M.D.
• Palestine A Sewell, CRNP
• Michael Myungkee Shin, D.M.D.
• Eddie J Simmons
• Suzane Gomes Simon, RN
• Nicklesh N Singh, M.D.
• Claudia Ann Smith

• Family Nurse Practitioner in Fort George G Meade, MD
• Providers in Fort George G Meade, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.