Active NPI
Shawnniece Tenay Pearson
- Health Service Psychologist
- Buffalo, NY
National Provider Identifier
1477076958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Psychologist
- License
- 294304071
- Practice address
- 45 A St
Buffalo, NY 14211-3203 - Phone
- (716) 370-0292
- NPI assigned
- Jul 17, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Psychologist | 103TH0100X | 294304071 | NY | Primary |
Addresses
Primary practice location
45 A St
Buffalo, NY 14211-3203
Mailing address
45 A Street
Buffalo, NY 14211
Phone (716) 370-0292
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 294304071 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 294304071 | NY | MD | Health Service Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1477076958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 A STREET",
"city": "BUFFALO",
"state": "NY",
"postal_code": "14211",
"telephone_number": "716-370-0292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 A ST",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142113203",
"telephone_number": "716-370-0292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSON",
"first_name": "SHAWNNIECE",
"middle_name": "TENAY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-17",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "NY",
"license": "294304071",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "294304071",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.