Active NPI
Shanice Douglas
- Social Worker
- Somerville, TN
National Provider Identifier
1346750163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 11343
- Practice address
- 12615 S Main St
Somerville, TN 38068-1673 - Phone
- (901) 465-9831
- NPI assigned
- Oct 6, 2017
- Last updated
- Oct 6, 2017
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 11343 | TN | Primary |
Addresses
Primary practice location
12615 S Main St
Somerville, TN 38068-1673
Mailing address
1997 Highway 51 S
Covington, TN 38019-3630
Phone (901) 476-8967
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507248000000",
"number": "1346750163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1997 HIGHWAY 51 S",
"city": "COVINGTON",
"state": "TN",
"postal_code": "380193630",
"telephone_number": "901-476-8967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12615 S MAIN ST",
"city": "SOMERVILLE",
"state": "TN",
"postal_code": "380681673",
"telephone_number": "901-465-9831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "SHANICE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-06",
"last_updated": "2017-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TN",
"license": "11343",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Somerville, TN
- David L Seaton (Seaton Family Practice)
- Deborah Louise Davis, CPHT
- Deanna Elsea, M.D. (Somerville Medical Clinic)
- DJB Pharmacy LLC (DJB Pharmacy)
- Doc Supply of West Tennessee, LLC
- Dwayne F Richardson DDS Estate (Richardson Family Dentistry)
- Elite Pediatric and Adolescent Medicine
- Michelle G Elrod, FNP-C
- Encore Health and Wellness PLLC
- Excelsior Podiatry Clinic PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.