Individual provider Active NPI

Annemarie Shah, LVN

  • Licensed Vocational Nurse
  • Van Nuys, CA
National Provider Identifier
1457549735
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
S113692 Issued in CA
Practice address
6931 Van Nuys Blvd
3Rd Floor
Van Nuys, CA 91405-3937
Phone
(818) 374-6901
Fax
(818) 373-4830
NPI assigned
Oct 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X S113692 CA Primary

Addresses

Primary practice location

6931 Van Nuys Blvd
3Rd Floor
Van Nuys, CA 91405-3937

Mailing address

24023 Cape May CT
Valencia, CA 91355-3317
Phone (661) 290-2409

Other identifiers 1

IdentifierTypeStateIssuer
7322-AOtherCACOUNTY PROVIDER

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

LicenseStateTypeSpecialty
S113692CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1457549735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24023 CAPE MAY CT",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913553317",
            "telephone_number": "661-290-2409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6931 VAN NUYS BLVD",
            "address_2": "3RD FLOOR",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053937",
            "telephone_number": "818-374-6901",
            "fax_number": "818-373-4830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "ANNEMARIE",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "S113692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNTY PROVIDER",
            "identifier": "7322-A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; 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.