Individual provider Active NPI

Shekika Poole, CPT

  • Phlebotomy Technician
  • Madison, MS
National Provider Identifier
1730937194
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
License
R5G2C6H7 Issued in MS
Practice address
272 Calhoun Station Pkwy Ste C1191
Madison, MS 39110-5540
Phone
(601) 873-3103
Fax
(601) 258-7303
NPI assigned
May 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X R5G2C6H7 MS Primary

Addresses

Primary practice location

272 Calhoun Station Pkwy Ste C1191
Madison, MS 39110-5540

Mailing address

272 Calhoun Station Pkwy Ste C1191
Madison, MS 39110-5540
Phone (601) 873-3103

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

State licenses

LicenseStateTypeSpecialty
R5G2C6H7MSMDPhlebotomy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Vamps on Wheels LLC Phlebotomy CurrentSince May 12, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1730937194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 CALHOUN STATION PKWY STE C1191",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391105540",
            "telephone_number": "601-873-3103",
            "fax_number": "601-258-7303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 CALHOUN STATION PKWY STE C1191",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391105540",
            "telephone_number": "601-873-3103",
            "fax_number": "601-258-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "SHEKIKA",
        "credential": "CPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-10",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "MS",
            "license": "R5G2C6H7",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; 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.