Shanequa Campbell, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

084021 Issued in NC

Practice address

12004 Journeys End TRL
Huntersville, NC 28078-2387

Phone

(615) 589-0501

NPI assigned

Oct 23, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Leaf Green Essential Solutions, LLC

  • Point of Service
  • Huntersville, NC
  • NPI 1558039479
  NPD Authorized official
• Amelicare

  • Home Health Agency
  • Ridgeland, MS
  • NPI 1548155633
  NPD Authorized official

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

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1457994352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12004 JOURNEYS END TRL",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280782387",
            "telephone_number": "615-589-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12004 JOURNEYS END TRL",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280782387",
            "telephone_number": "615-589-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "SHANEQUA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-23",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NC",
            "license": "84021",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NC",
            "license": "084021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susana Analia Camarasa, MS
• Cami Surgery Center, PLLC
• Dennis Campbell, PTA
• Elaine Lao Campbell, D.O.
• Scotty J Campbell, CRNA
• Ryan Thomas Cannici, NP
• Alyndra Baham Canty
• Canvas & Glow Aesthetiq, PC
• Peter Joseph Capizzi, M.D.
• Emmanuel Atienza Carandang, PHARMD.

• Licensed Practical Nurse in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Licensed Practical Nurse in North Carolina

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