Individual provider Active NPI

Shawna Marie Unger, LPN

  • Licensed Practical Nurse
  • Fairport, NY
National Provider Identifier
1578719910
Registry record updated Aug 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
257235-1 Issued in NY
Practice address
19 Squirrels Heath Road
Fairport, NY 14450-9605
Phone
(585) 425-0927
NPI assigned
Aug 18, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2008

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 257235-1 NY Primary

Addresses

Primary practice location

19 Squirrels Heath Road
Fairport, NY 14450-9605

Mailing address

19 Squirrels Heath Rd
Fairport, NY 14450-9605
Phone (585) 425-0927

Other identifiers 1

IdentifierTypeStateIssuer
02396578MedicaidNY

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
257235-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219017600000",
    "number": "1578719910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 SQUIRRELS HEATH RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144509605",
            "telephone_number": "585-425-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 SQUIRRELS HEATH ROAD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144509605",
            "telephone_number": "585-425-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNGER",
        "first_name": "SHAWNA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-18",
        "last_updated": "2008-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "257235-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02396578",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; 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.