Individual provider Active NPI

Shakeithdra Lee, RN

  • Registered Nurse
  • Duncanville, TX
National Provider Identifier
1508530320
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
899799 Issued in TX
Practice address
1810 Green Tree LN
Duncanville, TX 75137-3612
Phone
(281) 630-2328
NPI assigned
Aug 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 899799 TX Primary

Addresses

Primary practice location

1810 Green Tree LN
Duncanville, TX 75137-3612

Mailing address

1810 Green Tree LN
Duncanville, TX 75137-3612
Phone (281) 630-2328

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
899799TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1508530320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 GREEN TREE LN",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751373612",
            "telephone_number": "281-630-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 GREEN TREE LN",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751373612",
            "telephone_number": "281-630-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SHAKEITHDRA",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "899799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncanville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.