Active NPI
Shirley Mae Yeary, AAS
- Radiology Practitioner Assistant
- Minneapolis, MN
National Provider Identifier
1740375716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiology Practitioner Assistant
- License
- 262842
- Practice address
- 500 Harvard St SE
Unit J2-300
Minneapolis, MN 55455-0363 - Phone
- (612) 273-6004
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiology Practitioner Assistant | 243U00000X | 262842 | MN | Primary |
Addresses
Primary practice location
500 Harvard St SE
Unit J2-300
Minneapolis, MN 55455-0363
Mailing address
420 Delaware St SE MMC 292
University of Minnesota Physicians
Minneapolis, MN 55455
Phone (612) 273-6004
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
- Credentials
- Associate of Applied Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 262842 | MN | MD | Radiology Practitioner Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224547200000",
"number": "1740375716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 DELAWARE ST SE MMC 292",
"address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55455",
"telephone_number": "612-273-6004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 HARVARD ST SE",
"address_2": "UNIT J2-300",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554550363",
"telephone_number": "612-273-6004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YEARY",
"first_name": "SHIRLEY",
"middle_name": "MAE",
"credential": "AAS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2008-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "243U00000X",
"taxonomy_group": "",
"desc": "Radiology Practitioner Assistant",
"state": "MN",
"license": "262842",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.