Individual provider Active NPI

Shawnda A Wilson-Pryor, STNA

  • Nurse's Aide
  • Cincinnati, OH
National Provider Identifier
1629810460
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
378661811299 Issued in OH
Practice address
2986 High Forest LN Apt 119
Cincinnati, OH 45223-1335
Phone
(513) 978-8760
NPI assigned
Jun 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's AideGroup: 193400000X SINGLE SPECIALTY GROUP 376K00000X 378661811299 OH Primary

Addresses

Primary practice location

2986 High Forest LN Apt 119
Cincinnati, OH 45223-1335

Mailing address

2986 High Forest LN Apt 119
Cincinnati, OH 45223-1335
Phone (513) 978-8760

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
378661811299OHMDNurse's Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Grandmalove LLC Single Specialty CurrentSince Jun 16, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1629810460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2986 HIGH FOREST LN APT 119",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452231335",
            "telephone_number": "513-978-8760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2986 HIGH FOREST LN APT 119",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452231335",
            "telephone_number": "513-978-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON-PRYOR",
        "first_name": "SHAWNDA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "STNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "378661811299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.