Shanita Roshawn Shuford, MEDICAL WIG PROVIDER

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Practice address

125 N Trado St Suite D
Statesville, NC 28677

Phone

(828) 571-8564

NPI assigned

Nov 26, 2024

Sex

Female

Sole proprietor

Yes

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shanita Bundles Medical Collection LLC

  • Durable Medical Equipment & Medical Supplies
  • Statesville, NC
  • NPI 1649100512
  NPD (past) Authorized official

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1619793486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6602 STATESVILLE NC 28687",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "28687",
            "telephone_number": "980-316-8921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N TRADO ST SUITE D",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "28677",
            "telephone_number": "828-571-8564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUFORD",
        "first_name": "SHANITA",
        "middle_name": "ROSHAWN",
        "name_prefix": "Miss",
        "credential": "MEDICAL WIG PROVIDER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-26",
        "last_updated": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Marie Sheybani-Agdam, LPN
• Gregory Shields
• Shining Stars Home Health Agency
• John Isenhour Shoaf, PA-C
• Pam Westmoreland Sholar, MD
• Aerielle Brenae Sibert, PA-C
• Kimberly Rae Siegrist, NP
• Mary Daniela Silguero Rubio, DMD
• Silhouette Enterprises
• Kathryn Reece Simmons, RPH

• Prosthetic/Orthotic Supplier in Statesville, NC
• Providers in Statesville, NC by specialty
• Prosthetic/Orthotic Supplier in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.