Individual provider Active NPI

Natalya Shestakova, LPN

  • Licensed Practical Nurse
  • Mayfield HTS, OH
National Provider Identifier
1609181270
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN.126892 IV Issued in OH
Practice address
6312 Maplewood Rd
G 203
Mayfield HTS, OH 44124-1848
Phone
(330) 881-5553
NPI assigned
Aug 8, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2010

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 PN.126892 IV OH Primary

Addresses

Primary practice location

6312 Maplewood Rd
G 203
Mayfield HTS, OH 44124-1848

Mailing address

6312 Maplewood Rd
G 203
Mayfield HTS, OH 44124-1848
Phone (330) 881-5553

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
PN.126892 IVOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1281225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281312000000",
    "number": "1609181270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6312 MAPLEWOOD RD",
            "address_2": "G 203",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441241848",
            "telephone_number": "330-881-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6312 MAPLEWOOD RD",
            "address_2": "G 203",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441241848",
            "telephone_number": "330-881-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHESTAKOVA",
        "first_name": "NATALYA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-08",
        "last_updated": "2010-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.126892 IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield HTS, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; 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.