Shanika McCall, MEDICAL TATTOO

Primary specialty

Medical Art Specialist/TechnologistTaxonomy code 246ZA2600X

License

5026611640 Issued in NC

Practice address

500 N Reilly Rd Ste 122
Fayetteville, NC 28303-2452

Phone

(910) 988-7166

NPI assigned

Mar 17, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Chanel Luxxe Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1730837758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 HUNTLEY CT",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283762276",
            "telephone_number": "702-843-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N REILLY RD STE 122",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283032452",
            "telephone_number": "910-988-7166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALL",
        "first_name": "SHANIKA",
        "credential": "MEDICAL TATTOO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-17",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZA2600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Art, Medical",
            "state": "NC",
            "license": "5026611640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@chanellluxxe.com",
            "affiliation": "N",
            "address_1": "500 N Reilly Rd Ste 122",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283032452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHANEL",
            "last_name": "LUXXE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Tyshequa N McBride, LCMHC, LCAS
• Mikaela McBryde
• Shavon Lavette McCain, LCSWA; LCASA
• Catherine McCall, DPT
• Philip Neil McCall, M.A.
• Kelsey McCann, PA-C
• Valarie McCants, LCSW
• Sybil Anne McCarrol, LCMHCA
• Kyle Jeffrey McCarthy, PA-C
• McCay Pediatric Speech & Language Services PLLC

• Medical Art Specialist/Technologist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Medical Art Specialist/Technologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; 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.