Individual provider Active NPI

Shakemia Shaw, LPN

  • Licensed Practical Nurse
  • Somerville, MA
National Provider Identifier
1649710963
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LN92594 Issued in MA
Practice address
230 Highland Avenue
Somerville, MA 02143
Phone
(617) 591-4252
NPI assigned
Mar 6, 2017
Last updated
Mar 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LN92594 MA Primary

Addresses

Primary practice location

230 Highland Avenue
Somerville, MA 02143

Mailing address

230 Highland Ave
Somerville, MA 02143-1408

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
LN92594MAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1649710963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 HIGHLAND AVE",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021431408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 HIGHLAND AVENUE",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "02143",
            "telephone_number": "617-591-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "SHAKEMIA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-06",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MA",
            "license": "LN92594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.

Verify at the official NPI Registry.