Active NPI
Shaquonza Houston
- Phlebotomy Technician
- Fairburn, GA
National Provider Identifier
1336960467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebotomy Technician
- License
- 451241677187112
- Practice address
- 5900 Bluegrass VW Apt Suite
Fairburn, GA 30213-4736 - Phone
- (678) 876-7906
- NPI assigned
- Oct 21, 2024
- Last updated
- Oct 28, 2024
- 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 |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | 451241677187112 | GA | Primary |
Addresses
Primary practice location
5900 Bluegrass VW Apt Suite
Fairburn, GA 30213-4736
Mailing address
154 Rainbow Way # 299
Fayetteville, GA 30214-3994
Phone (888) 462-6602
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 451241677187112 | GA | MD | Phlebotomy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730073600000",
"number": "1336960467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "154 RAINBOW WAY # 299",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302143994",
"telephone_number": "888-462-6602",
"fax_number": "770-202-7167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 BLUEGRASS VW APT SUITE",
"city": "FAIRBURN",
"state": "GA",
"postal_code": "302134736",
"telephone_number": "678-876-7906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOUSTON",
"first_name": "SHAQUONZA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-21",
"last_updated": "2024-10-28",
"certification_date": "2024-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": "GA",
"license": "451241677187112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairburn, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.