NPIMap

Individual provider Active NPI

Shaneekwa Shaunte Perkins, DPM

  • Foot & Ankle Surgery Podiatrist
  • Apple Valley, CA
National Provider Identifier
1689998916
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
6050 Issued in CA
Practice address
18056 Wika Rd Ste C
Apple Valley, CA 92307-2194
Phone
(760) 628-2021
Fax
(760) 867-3302
NPI assigned
Mar 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PD2394 MA
Foot & Ankle Surgery Podiatrist 213ES0103X LL9564 MD
Student in an Organized Health Care Education/Training Program 390200000X IA
Foot & Ankle Surgery Podiatrist 213ES0103X 6050 CA Primary

Addresses

Primary practice location

18056 Wika Rd Ste C
Apple Valley, CA 92307-2194

Mailing address

10 West St
Unit 7
West Hatfield, MA 01088-9554
Phone (413) 397-8900

Other names 1

  • Nikki Perkins Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240828005074 CA Practitioner - Podiatry 7012157860 Reassigns benefits to 1 organization
I20241014000741 TX Practitioner - Podiatry 7012157860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choctaw Nation of OklahomaGroup PAC ID 1759294838, 271 clinicians

Practice addresses (Care Compare)

109 Kerr Blvd
Poteau, OK 74953-5231
Phone (539) 316-6391

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue19
Removal of nail tissue36
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2394MAMDRegistered Dietitian
PD2394MAMDFoot & Ankle Surgery Podiatrist
LL9564MDMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey Demian Inc Foot & Ankle Surgery CurrentSince Jul 19, 2024 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Sep 30, 2024 Accepting new patients
Choctaw Nation of Oklahoma Current Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Sep 30, 2024 Accepting new patients
Choctaw Nation of Oklahoma Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients

Locations

17215 Studebaker Rd
Ste 108
Cerritos, CA 90703
Phone (310) 750-4511

1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981

1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204

410 N M St
Hugo, OK 74743
Phone (580) 326-7561

902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600

1127 S George Nigh Expy
McAlester, OK 74501
Phone (800) 349-7026

109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100

2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636

Interoperability endpoints

  • Direct secure messaging: sperkins24162@choctawnation.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1689998916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WEST ST",
            "address_2": "UNIT 7",
            "city": "WEST HATFIELD",
            "state": "MA",
            "postal_code": "010889554",
            "telephone_number": "413-397-8900",
            "fax_number": "413-247-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18056 WIKA RD STE C",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072194",
            "telephone_number": "760-628-2021",
            "fax_number": "760-867-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "SHANEEKWA",
        "middle_name": "SHAUNTE",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-15",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MA",
            "license": "PD2394",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MD",
            "license": "LL9564",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IA",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "6050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NIKKI",
            "last_name": "PERKINS",
            "credential": "DPM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Apple Valley, CA

Sources for this page

Verify at the official NPI Registry.