Shawn Lamont Tally

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

1115 Ball Ave NE
Grand Rapids, MI 49505-5904

Phone

(616) 456-6571

NPI assigned

Sep 11, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1447733951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 HOVEY ST SW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495046154",
            "telephone_number": "313-980-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 BALL AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055904",
            "telephone_number": "616-456-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLY",
        "first_name": "SHAWN",
        "middle_name": "LAMONT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vidyulatha Talla, MD
• Colleen Cheri Tallen, MD
• Lorelle Joy Tallent, PA
• Nicole Lucia Talley, MD
• Jill D Tallman, PA-C
• Elizabeth Ann Talsma, CRNA
• Maximiliano Andres Tamae Kakazu, MD
• Alexay Ann Tamas, DMD
• Maria Tamayo-Rodriguez
• Lisa Tamblyn, LPC

• Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.