Individual provider Active NPI

Shamica Neal

  • Peer Specialist
  • Dallas, TX
National Provider Identifier
1740016195
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
10500 Lake June Rd Apt F2
Dallas, TX 75217-3370
Phone
(469) 643-0609
NPI assigned
Sep 11, 2024
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

10500 Lake June Rd Apt F2
Dallas, TX 75217-3370

Mailing address

10500 Lake June Rd Apt F2
Dallas, TX 75217-3370
Phone (469) 643-0609

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

NPI Registry JSON

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

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1740016195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10500 LAKE JUNE RD APT F2",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752173370",
            "telephone_number": "469-643-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10500 LAKE JUNE RD APT F2",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752173370",
            "telephone_number": "469-643-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "SHAMICA",
        "sole_proprietor": "YES",
        "sex": "U",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.