Individual provider Active NPI

Shamona Duffus

  • Clinical Social Worker
  • Tallahassee, FL
National Provider Identifier
1356648950
Registry record updated Sep 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW10435 Issued in FL
Practice address
438 W Brevard St
Tallahassee, FL 32301-1004
Phone
(850) 224-2469
Fax
(850) 224-1139
NPI assigned
Feb 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW10435 FL Primary
Social Worker 104100000X ISW5763 FL

Addresses

Primary practice location

438 W Brevard St
Tallahassee, FL 32301-1004

Mailing address

438 W Brevard St
Tallahassee, FL 32301-1004
Phone (850) 224-2469

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

State licenses

LicenseStateTypeSpecialty
ISW5763FLMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1297814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1356648950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 W BREVARD ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323011004",
            "telephone_number": "850-224-2469",
            "fax_number": "850-224-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 W BREVARD ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323011004",
            "telephone_number": "850-224-2469",
            "fax_number": "850-224-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFFUS",
        "first_name": "SHAMONA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-16",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10435",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "ISW5763",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; 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.