Individual provider Active NPI

Shavica Shortte

  • Substance Abuse Rehabilitation Facility
  • Northampton, MA
National Provider Identifier
1841620903
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Practice address
143 West St
Northampton, MA 01060-3749
Phone
(413) 586-8213
Fax
(413) 585-9139
NPI assigned
Nov 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

143 West St
Northampton, MA 01060-3749

Mailing address

1695 Main St
Ste 300
Springfield, MA 01103-1348
Phone (413) 739-5572

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

NPI Registry JSON

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

{
    "created_epoch": "1385424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1841620903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 MAIN ST",
            "address_2": "STE 300",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011031348",
            "telephone_number": "413-739-5572",
            "fax_number": "413-739-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 WEST ST",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010603749",
            "telephone_number": "413-586-8213",
            "fax_number": "413-585-9139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORTTE",
        "first_name": "SHAVICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-26",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northampton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.

Verify at the official NPI Registry.