Individual provider Active NPI

Shauna Rachelle Jones-Grandberry, DRIVER

  • Non-emergency Medical Transport (VAN)
  • Memphis, TN
National Provider Identifier
1811335920
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
070890852 Issued in TN
Practice address
940 Mississippi Blvd
3898 Dante Cove
Memphis, TN 38126-5704
Phone
(901) 378-6639
Fax
(901) 948-2103
NPI assigned
Jun 11, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X 070890852 TN Primary

Addresses

Primary practice location

940 Mississippi Blvd
3898 Dante Cove
Memphis, TN 38126-5704

Mailing address

940 Mississippi Blvd
Memphis, TN 38126-5704
Phone (901) 378-6639

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

LicenseStateTypeSpecialty
070890852TNMDNon-emergency Medical Transport (VAN)

NPI Registry JSON

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1811335920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 MISSISSIPPI BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381265704",
            "telephone_number": "901-378-6639",
            "fax_number": "901-948-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 MISSISSIPPI BLVD",
            "address_2": "3898 DANTE COVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381265704",
            "telephone_number": "901-378-6639",
            "fax_number": "901-948-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES-GRANDBERRY",
        "first_name": "SHAUNA",
        "middle_name": "RACHELLE",
        "name_prefix": "Mrs.",
        "credential": "DRIVER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-11",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "TN",
            "license": "070890852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; 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.