Shandis Denise Phaneuf, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LON066099 Issued in GA

Practice address

6545 Gregg Dr
Columbus, GA 31909

Phone

(334) 663-4278

NPI assigned

Feb 5, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Shandis Denise Phaneuf Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1477185791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 GREGG DR",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319093273",
            "telephone_number": "334-663-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 GREGG DR",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31909",
            "telephone_number": "334-663-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHANEUF",
        "first_name": "SHANDIS",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LON066099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANDIS",
            "last_name": "PHANEUF",
            "middle_name": "DENISE",
            "prefix": "MRS.",
            "credential": "SHANDIS PHANEUF LPN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Tyleasha S Pettway
• Eric T. Petty, PT
• Jeremy Petty, FNP-C
• Deliana Peykova, MD
• Cynthia Pfeifler, RRT
• Kiara Phelps, MD
• Sabin Phelps
• Tiffany Michelle Phelps, LPN
• Angus P Phelts III, MD
• Ashlie Michelle Phillips

• Licensed Practical Nurse in Columbus, GA
• Providers in Columbus, GA by specialty
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.