Active NPI
Shardae Grate
- Homemaker
- Philadelphia, PA
National Provider Identifier
1790308732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- License
- 40963601
- Practice address
- 6542 N Mascher St
Philadelphia, PA 19120-1040 - Phone
- (267) 212-2954
- NPI assigned
- May 26, 2020
- 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 |
|---|---|---|---|---|
| Homemaker | 376J00000X | 40963601 | PA | Primary |
Addresses
Primary practice location
6542 N Mascher St
Philadelphia, PA 19120-1040
Mailing address
6542 N Mascher St
Philadelphia, PA 19120-1040
Phone (267) 212-2954
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103732466-0001 | Medicaid | PA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 40963601 | PA | MD | Homemaker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590451200000",
"number": "1790308732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6542 N MASCHER ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191201040",
"telephone_number": "267-212-2954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6542 N MASCHER ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191201040",
"telephone_number": "267-212-2954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRATE",
"first_name": "SHARDAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-26",
"last_updated": "2020-05-26",
"certification_date": "2020-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "PA",
"license": "40963601",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103732466-0001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.