Shauntae Marie Dixon

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

343900000X Issued in IN

Practice address

23191 Lawrence St
23191 Lawrence St
South Bend, IN 46628-5250

Phone

(574) 234-3107

Fax

(574) 234-3107

NPI assigned

Jun 17, 2008

Last updated

Jun 17, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Shauntae Marie Deloach Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1346401957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23191 LAWRENCE ST",
            "address_2": "23191 LAWRENCE ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466285250",
            "telephone_number": "574-234-3107",
            "fax_number": "574-234-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23191 LAWRENCE ST",
            "address_2": "23191 LAWRENCE ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466285250",
            "telephone_number": "574-234-3107",
            "fax_number": "574-234-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "SHAUNTAE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-17",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "IN",
            "license": "343900000X",
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "IN",
            "license": "1728808",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAUNTAE",
            "last_name": "DELOACH",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shane Michael Ditty, MD
• Divine Favor LLC
• Divine Interventions Inc.
• Marie Kathleen Dix, MD
• Marquette Dixon, MA
• Jacob Daniel Dobransky, LMSW
• Maggie Dobrodt
• Douglas Dean Doctor, M.D.
• Grace Dodd
• Judy Dodd, LPN

• Non-emergency Medical Transport (VAN) in South Bend, IN
• Providers in South Bend, IN by specialty
• Non-emergency Medical Transport (VAN) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.