Individual provider Active NPI

Shanda S Robinson

  • Counselor
  • Philadelphia, PA
National Provider Identifier
1497419980
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
8013 Hollis St
Philadelphia, PA 19150-3510
Phone
(215) 407-0587
NPI assigned
Oct 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X PA Primary

Addresses

Primary practice location

8013 Hollis St
Philadelphia, PA 19150-3510

Mailing address

8013 Hollis St
Philadelphia, PA 19150-3510
Phone (215) 407-0587

Other names 1

  • Miss Shanda S Goodman Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1635465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1497419980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8013 HOLLIS ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191503510",
            "telephone_number": "215-407-0587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8013 HOLLIS ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191503510",
            "telephone_number": "215-407-0587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "SHANDA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-29",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANDA",
            "last_name": "GOODMAN",
            "middle_name": "S",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

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