Individual provider Active NPI

Shanta E Dawson, CPNP

  • Pediatric Nurse Practitioner
  • Epping, NH
National Provider Identifier
1346201134
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0359152302 Issued in NH
Practice address
212 Calef Hwy
Epping, NH 03042-2322
Phone
(603) 693-2100
NPI assigned
Mar 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0359152302 NH Primary

Addresses

Primary practice location

212 Calef Hwy
Epping, NH 03042-2322

Mailing address

7 Holland Way FL 1
Exeter, NH 03833-2997
Phone (603) 693-2100

Other identifiers 1

IdentifierTypeStateIssuer
3076880MedicaidNH

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
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0359152302NHMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1346201134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 HOLLAND WAY FL 1",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038332997",
            "telephone_number": "603-693-2100",
            "fax_number": "603-679-1046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 CALEF HWY",
            "city": "EPPING",
            "state": "NH",
            "postal_code": "030422322",
            "telephone_number": "603-693-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "SHANTA",
        "middle_name": "E",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NH",
            "license": "0359152302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3076880",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Epping, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.