Shantise Michelle LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

SHANTISE MICHELLE LLC

Doing business as

Shantise Michelle Cranial Prosthesis

Practice address

2040 Millburn Ave Ste 305
Maplewood, NJ 07040-3716

Phone

(973) 901-3640

NPI assigned

Aug 6, 2020

Last updated

Feb 9, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Shantise ParkerNPI 1881458792

Title

Owner

Phone

(973) 901-3640

Specialties & licenses 1

Addresses

Other names 1

• Shantise Michelle Cranial Prosthesis Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shantise Parker

  • Prosthetic/Orthotic Supplier
  • Maplewood, NJ
  • NPI 1881458792
  NPD Authorized official

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707436800000",
    "number": "1639789340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 MILLBURN AVE STE 305",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403716",
            "telephone_number": "973-901-3640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 MILLBURN AVE STE 305",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403716",
            "telephone_number": "973-901-3640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANTISE MICHELLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-06",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "SHANTISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-901-3640",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shantise Michelle Cranial Prosthesis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dorsa Seimaa
• Seniorscom Care, Inc (all season care, inc)
• Clarencia Shade, LCSW
• Yusuf Nathaniel Shaheed, LCADC
• Laquan R Shamberger
• Robert Shekitka, DMD
• Lancy Siby
• Susan D Siegeltuch, LCSW
• Rejane Signor, NP
• Mylisha Simmons-Rutty, LMSW, LSW

• Prosthetic/Orthotic Supplier in Maplewood, NJ
• Providers in Maplewood, NJ by specialty
• Prosthetic/Orthotic Supplier in New Jersey

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