Shine Senior Center

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

TBA Issued in MD

Legal business name

SHINE SENIOR CENTER

Practice address

9198 Red Branch Rd Ste H
Columbia, MD 21045-2017

Phone

(301) 310-3067

Fax

(410) 772-3933

NPI assigned

Jul 21, 2015

Organization subpart

No

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

Authorized official

Name

Seongbok Lee

Title

President

Phone

(301) 821-7214

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437436800000",
    "number": "1700261633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9198 RED BRANCH RD STE H",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452017",
            "telephone_number": "301-310-3067",
            "fax_number": "410-772-3933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9198 RED BRANCH RD STE H",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452017",
            "telephone_number": "301-310-3067",
            "fax_number": "410-772-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINE SENIOR CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-21",
        "last_updated": "2015-07-21",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "SEONGBOK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-821-7214"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "MD",
            "license": "TBA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Jared Shimoda, PHARM D
• Lawrence Shin, M.D.
• Maria Fiedes Shin
• Theresa M. Shin, O.D.
• Timothy Shin, CRNA
• Towanda Shine
• Shirley E. Reddoch, MD, LLC
• Sangeeta Shirodkar-Chatim, RPH
• Emily Navarro Shiver
• Mana Shoeybi, DDS

• Adult Day Care Clinic/Center in Columbia, MD
• Providers in Columbia, MD by specialty
• Adult Day Care Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.