Individual provider Active NPI

Shonetell Renee Ross, LPN

  • Licensed Practical Nurse
  • Lafayette, LA
National Provider Identifier
1558074062
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
20180242 Issued in LA
Practice address
121 Barnett CT
Lafayette, LA 70507-2764
Phone
(337) 200-0372
NPI assigned
Dec 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 20180242 LA Primary

Addresses

Primary practice location

121 Barnett CT
Lafayette, LA 70507-2764

Mailing address

121 Barnett CT
Lafayette, LA 70507-2764
Phone (337) 200-0372

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shonetell.ross@merakey.org Direct

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

State licenses

LicenseStateTypeSpecialty
20180242LAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1672272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1558074062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 BARNETT CT",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705072764",
            "telephone_number": "337-200-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BARNETT CT",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705072764",
            "telephone_number": "337-200-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "SHONETELL",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-29",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "LA",
            "license": "20180242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shonetell.ross@merakey.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "121 Barnett Ct",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705072764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; 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.