Active NPI
Shafiah Pearl
- Licensed Practical Nurse
- Cleveland, OH
National Provider Identifier
1609381367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 166012
- Practice address
- 11313 Proctor CT
Cleveland, OH 44105-6246 - Phone
- (216) 738-9402
- NPI assigned
- Dec 4, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 166012 | OH | Primary |
Addresses
Primary practice location
11313 Proctor CT
Cleveland, OH 44105-6246
Mailing address
11313 Proctor CT
Cleveland, OH 44105-6246
Other practice location 1
11313 Proctor Ct
Cleveland, OH 44105-6246
Phone (216) 738-9402
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 166012 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 166012 | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512345600000",
"number": "1609381367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11313 PROCTOR CT",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441056246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11313 PROCTOR CT",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441056246",
"telephone_number": "216-738-9402"
}
],
"practiceLocations": [
{
"address_1": "11313 Proctor Ct",
"address_purpose": "LOCATION",
"city": "Cleveland",
"state": "OH",
"postal_code": "441056246",
"country_code": "US",
"telephone_number": "216-738-9402",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEARL",
"first_name": "SHAFIAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-04",
"last_updated": "2017-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "166012",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "166012",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.