Active NPI
Pamela Kaye Shadley, CNS
- Neuroscience Clinical Nurse Specialist
- Dayton, OH
National Provider Identifier
1801009485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuroscience Clinical Nurse Specialist
- License
- APRN.CNS.02175
- Practice address
- 30 E Apple St Ste 5254a
Dayton, OH 45409-2939 - Phone
- (937) 208-4200
- Fax
- (937) 208-4205
- NPI assigned
- May 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Neuroscience Clinical Nurse Specialist | 364SN0800X | APRN.CNS.02175 | OH | Primary |
Addresses
Primary practice location
30 E Apple St Ste 5254a
Dayton, OH 45409-2939
Mailing address
30 E Apple St Ste 5254a
Dayton, OH 45409-2939
Phone (937) 208-4200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0095580 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Certified Nurse Specialist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN.CNS.02175 | OH | MD | Neuroscience Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540857600000",
"number": "1801009485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 E APPLE ST STE 5254A",
"city": "DAYTON",
"state": "OH",
"postal_code": "454092939",
"telephone_number": "937-208-4200",
"fax_number": "937-208-4205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 E APPLE ST STE 5254A",
"city": "DAYTON",
"state": "OH",
"postal_code": "454092939",
"telephone_number": "937-208-4200",
"fax_number": "937-208-4205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHADLEY",
"first_name": "PAMELA",
"middle_name": "KAYE",
"credential": "CNS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2018-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "364SN0800X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Neuroscience",
"state": "OH",
"license": "APRN.CNS.02175",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0095580",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.