Active NPI
Shannon Renee Gregory
- School Counselor
- Laveen, AZ
National Provider Identifier
1356589402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Counselor
- License
- 4057121
- Practice address
- 4725 W South Mountain Ave
Laveen, AZ 85339 - Phone
- (602) 237-7040
- Fax
- (602) 237-3376
- NPI assigned
- Jan 28, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| School Counselor | 101YS0200X | 4057121 | AZ | Primary |
Addresses
Primary practice location
4725 W South Mountain Ave
Laveen, AZ 85339
Mailing address
5010 E Cheyenne Dr
#1041
Phoenix, AZ 85044-1770
Phone (614) 403-5159
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 |
|---|---|---|---|
| 4057121 | AZ | MD | School Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233100800000",
"number": "1356589402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5010 E CHEYENNE DR",
"address_2": "#1041",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850441770",
"telephone_number": "614-403-5159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4725 W SOUTH MOUNTAIN AVE",
"city": "LAVEEN",
"state": "AZ",
"postal_code": "85339",
"telephone_number": "602-237-7040",
"fax_number": "602-237-3376"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREGORY",
"first_name": "SHANNON",
"middle_name": "RENEE",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-28",
"last_updated": "2009-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": "AZ",
"license": "4057121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laveen, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.