Individual provider Active NPI

Amanda Katheryn Shockey, RN, ATC

  • Athletic Trainer
  • Norfolk, VA
National Provider Identifier
1689113391
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0126001645 Issued in VA
Practice address
171 Kempsville Rd
Building a
Norfolk, VA 23502-4700
Phone
(757) 668-6550
NPI assigned
Feb 14, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0126001645 VA Primary

Addresses

Primary practice location

171 Kempsville Rd
Building a
Norfolk, VA 23502-4700

Mailing address

171 Kempsville Rd
Building a
Norfolk, VA 23502-4700
Phone (757) 668-6550

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
0126001645VAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1689113391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 KEMPSVILLE RD",
            "address_2": "BUILDING A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024700",
            "telephone_number": "757-668-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 KEMPSVILLE RD",
            "address_2": "BUILDING A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024700",
            "telephone_number": "757-668-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCKEY",
        "first_name": "AMANDA",
        "middle_name": "KATHERYN",
        "credential": "RN, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-14",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126001645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.