Active NPI
Claude Shukuru Sr.
- Rehabilitation Psychologist
- Avondale, AZ
National Provider Identifier
1508564741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Psychologist
- Practice address
- 2202 N 118TH LN
Avondale, AZ 85392-3060 - Phone
- (602) 883-6913
- NPI assigned
- Feb 17, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Rehabilitation Psychologist | 103TR0400X | AZ | Primary |
Addresses
Primary practice location
2202 N 118TH LN
Avondale, AZ 85392-3060
Mailing address
2202 N 118TH LN
Avondale, AZ 85392-3060
Phone (602) 883-6913
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D10279545 | Medicaid | AZ |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J&M Transit LLC | Current | Accepting new patients |
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.
-
- Non-emergency Medical Transport (VAN)
- Dayton, OH
- NPI 1548155138
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684886400000",
"number": "1508564741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2202 N 118TH LN",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853923060",
"telephone_number": "602-883-6913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2202 N 118TH LN",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853923060",
"telephone_number": "602-883-6913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUKURU",
"first_name": "CLAUDE",
"name_prefix": "Ms.",
"name_suffix": "Sr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-02-17",
"last_updated": "2023-05-24",
"certification_date": "2023-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TR0400X",
"taxonomy_group": "",
"desc": "Psychologist, Rehabilitation",
"state": "AZ",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D10279545",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Avondale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.