Shane Edward Bragg

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

1520 Irish MTN Rd
Shady Spring, WV 25918

Phone

(304) 222-1156

NPI assigned

Oct 13, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1548868474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2091",
            "city": "BEAVER",
            "state": "WV",
            "postal_code": "258132091",
            "telephone_number": "304-222-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 IRISH MTN RD",
            "city": "SHADY SPRING",
            "state": "WV",
            "postal_code": "25918",
            "telephone_number": "304-222-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAGG",
        "first_name": "SHANE",
        "middle_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-13",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Herbert J Baker
• Jessica Celine Barber
• Adrienne Leigh Berry
• Jaclyn Ruth Bolen, LICSW
• Melissa Gail Bragg
• Lesa J Buckland, MASTERS HS
• C Jeff Clay, D.D.S. Inc.
• Shyann Louise Callaway
• Gregory Wayne Castle
• Tonia Sue Castle

• Personal Care Attendant in Shady Spring, WV
• Providers in Shady Spring, WV by specialty
• Personal Care Attendant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.

Verify at the official NPI Registry.