Individual provider Active NPI

Shaquita Monae Watson

  • Home Health Aide
  • Chesapeake, VA
National Provider Identifier
1366028466
Registry record updated Mar 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
3210 Churchland Blvd Ste 5
Chesapeake, VA 23321-5253
Phone
(757) 785-6263
NPI assigned
Mar 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X Primary

Addresses

Primary practice location

3210 Churchland Blvd Ste 5
Chesapeake, VA 23321-5253

Mailing address

3210 Churchland Blvd Ste 5
Chesapeake, VA 23321-5253
Phone (757) 785-6263

Other identifiers 1

IdentifierTypeStateIssuer
861647313OtherIRS

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

Practice roles

OrganizationSpecialtyStatusNew patients
Miraculous Hands Home Healthcare CurrentSince Jun 12, 2022 Accepting new patients

Locations

3210 Churchland Blvd
Ste 5
Chesapeake, VA 23321
Phone (757) 484-5979

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1616198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616198400000",
    "number": "1366028466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 CHURCHLAND BLVD STE 5",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215253",
            "telephone_number": "757-785-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 CHURCHLAND BLVD STE 5",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215253",
            "telephone_number": "757-785-6263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "SHAQUITA",
        "middle_name": "MONAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-20",
        "last_updated": "2021-03-20",
        "certification_date": "2021-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS",
            "identifier": "861647313",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2021; 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.