Active NPI
Callief Shereen Shand, D.D.S.
- Dentist
- Chipley, FL
National Provider Identifier
1679791420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 17889
- Practice address
- 1338 South Blvd
Dental
Chipley, FL 32428-1846 - Phone
- (850) 638-6240
- NPI assigned
- Apr 24, 2007
- Last updated
- Jul 1, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 17889 | FL | Primary |
Addresses
Primary practice location
1338 South Blvd
Dental
Chipley, FL 32428-1846
Mailing address
774 Hoyt St
Apt 9
Chipley, FL 32428-1606
Phone (850) 445-0152
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 076745000 | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17889 | FL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Department of Health | Past | Accepting new patients | |
| Florida Department of Health | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Levy County Health Department
- Public Health or Welfare Agency
- Bronson, FL
- NPI 1154395390
-
dba Washington County Health Department
- Public Health or Welfare Agency
- Chipley, FL
- NPI 1780647529
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246406400000",
"number": "1679791420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "774 HOYT ST",
"address_2": "APT 9",
"city": "CHIPLEY",
"state": "FL",
"postal_code": "324281606",
"telephone_number": "850-445-0152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1338 SOUTH BLVD",
"address_2": "DENTAL",
"city": "CHIPLEY",
"state": "FL",
"postal_code": "324281846",
"telephone_number": "850-638-6240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAND",
"first_name": "CALLIEF",
"middle_name": "SHEREEN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-24",
"last_updated": "2009-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "17889",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "076745000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chipley, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.