Individual provider Active NPI

Shelby Michaela Janes, MS, LAT, ATC, CSCS

  • Athletic Trainer
  • Stanwood, WA
National Provider Identifier
1740804343
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
A161357374 Issued in WA
Practice address
21917 74TH Dr NW
Stanwood, WA 98292-6864
Phone
(206) 947-2330
NPI assigned
May 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X A161357374 WA Primary

Addresses

Primary practice location

21917 74TH Dr NW
Stanwood, WA 98292-6864

Mailing address

21917 74TH Dr NW
Stanwood, WA 98292-6864
Phone (206) 947-2330

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
Master of Science

State licenses

LicenseStateTypeSpecialty
A161357374WAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1590883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1740804343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21917 74TH DR NW",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982926864",
            "telephone_number": "206-947-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21917 74TH DR NW",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982926864",
            "telephone_number": "206-947-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANES",
        "first_name": "SHELBY",
        "middle_name": "MICHAELA",
        "credential": "MS, LAT, ATC, CSCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-31",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "A161357374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; 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.