Shaina Nishimura, AU.D.

Key facts

NPI

1700089786

Entity type

Individual (NPI type 1)

Primary specialty

Audiologist-Hearing Aid Fitter 237600000X

License

AT006107 (PA)

Practice address

8100 Roosevelt Blvd
Suite 202
Philadelphia, PA 19152-2900

Phone

(215) 535-5598

NPI assigned

Jun 7, 2007

Sex

Female

Sole proprietor

No

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 and National Provider Directory roles.

• Rem Audiology Associates, P.C. Audiologist-Hearing Aid Fitter · Philadelphia, PA · NPI 1124072665
  NPD (past) AUDIOLOGIST
• Audiology Services Company USA, LLC Hearing and Speech Clinic/Center · Somerset, NJ · NPI 1033585302
  NPD (past) AUDIOLOGIST

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 27, 2011.

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303862400000",
    "number": "1700089786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 HUNTERS LN",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542814",
            "telephone_number": "609-320-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 ROOSEVELT BLVD",
            "address_2": "SUITE 202",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522900",
            "telephone_number": "215-535-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHIMURA",
        "first_name": "SHAINA",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2011-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "0021291",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NJ",
            "license": "25MG00114200",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "PA",
            "license": "AT006107",
            "primary": true
        },
        {
            "code": "231HA2400X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Practitioner",
            "state": "PA",
            "license": "AT006107",
            "primary": false
        },
        {
            "code": "231HA2500X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Supplier",
            "state": "PA",
            "license": "AT006107",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NJ",
            "license": "41YA00073700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Philadelphia, PA · Audiologist-Hearing Aid Fitter in Pennsylvania