Individual provider Active NPI

Shanta Edinburgh, RN, PHN

  • Registered Nurse
  • San Diego, CA
National Provider Identifier
1346472248
Registry record updated Aug 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
670882 Issued in CA
Practice address
1600 Pacific Hwy RM 207
San Diego, CA 92101-2422
Phone
(619) 285-5585
NPI assigned
Aug 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 670882 CA Primary

Addresses

Primary practice location

1600 Pacific Hwy RM 207
San Diego, CA 92101-2422

Mailing address

1600 Pacific Hwy RM 207
San Diego, CA 92101-2422
Phone (619) 285-5585

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
670882CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249948800000",
    "number": "1346472248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 PACIFIC HWY RM 207",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012422",
            "telephone_number": "619-285-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 PACIFIC HWY RM 207",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012422",
            "telephone_number": "619-285-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDINBURGH",
        "first_name": "SHANTA",
        "credential": "RN, PHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-11",
        "last_updated": "2009-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "670882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2009; 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.