Shirley Borom, R.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

28093654A Issued in IN

Practice address

1145 W 5TH Ave
Gary, IN 46402-1704

Phone

(219) 882-5565

Fax

(219) 882-8213

NPI assigned

Jan 12, 2012

Sex

Female

Sole proprietor

No

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.

• Gary Health Department

  • Case Manager/Care Coordinator
  • Gary, IN
  • NPI 1659415214
  NPD (past)
• Gary Health Department

  • Registered Nurse
  • Gary, IN
  • NPI 1992075592
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 12, 2012.

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1649540261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 W 5TH AVE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464021704",
            "telephone_number": "219-882-5565",
            "fax_number": "219-882-8213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 W 5TH AVE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464021704",
            "telephone_number": "219-882-5565",
            "fax_number": "219-882-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOROM",
        "first_name": "SHIRLEY",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-12",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28093654A",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "IN",
            "license": "28093654A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100142050A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charity Boatright
• Kevin Scott Bodkin, D.O.
• Ryan J. Boilek, PTA
• Alyncia Bonner
• Camille A Borders, M.D.
• Mario Bovino, MD
• Lechristien Renee Box, MA
• Khawanda Kim Boyd, PBT
• Rahnaysha Diane Boyd
• Darius Brannon, B.A., CADAC II

• All providers in Gary, IN
• Registered Nurse in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; 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.