Individual provider Active NPI

Shawn Michael Veazey

  • Social Worker
  • Bay Pines, FL
National Provider Identifier
1487132528
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
12620 Issued in SC
Practice address
10000 Bay Pines Blvd BLDG T203
Bay Pines, FL 33744-8200
Phone
(727) 398-6661
NPI assigned
Jul 31, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 12620 SC Primary

Addresses

Primary practice location

10000 Bay Pines Blvd BLDG T203
Bay Pines, FL 33744-8200

Mailing address

4736 10TH Ave N
Saint Petersburg, FL 33713-6129
Phone (813) 245-3423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231220001095 FL Practitioner - Clinical Social Worker 5395195127 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12620SCMDPhysical Therapist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1487132528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4736 10TH AVE N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337136129",
            "telephone_number": "813-245-3423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 BAY PINES BLVD BLDG T203",
            "city": "BAY PINES",
            "state": "FL",
            "postal_code": "337448200",
            "telephone_number": "727-398-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEAZEY",
        "first_name": "SHAWN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "12620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Pines, FL

Sources for this page

Verify at the official NPI Registry.