Active NPI
Kimberly Shreeve
- Specialist
- Show Low, AZ
National Provider Identifier
1861524217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 0000
- Practice address
- 1801 W Deuce of Clubs
Show Low, AZ 85901-2705 - Phone
- (928) 537-7480
- Fax
- (928) 532-0255
- NPI assigned
- Mar 12, 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 0000 | AZ | Primary |
Addresses
Primary practice location
1801 W Deuce of Clubs
Show Low, AZ 85901-2705
Mailing address
200 N 4TH Ave
Show Low, AZ 85901-4648
Phone (928) 532-7171
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00000 | Other | AZ | FOSTER CARE |
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 |
|---|---|---|---|
| 0000 | AZ | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861524217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 N 4TH AVE",
"city": "SHOW LOW",
"state": "AZ",
"postal_code": "859014648",
"telephone_number": "928-532-7171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 W DEUCE OF CLUBS",
"city": "SHOW LOW",
"state": "AZ",
"postal_code": "859012705",
"telephone_number": "928-537-7480",
"fax_number": "928-532-0255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHREEVE",
"first_name": "KIMBERLY",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "AZ",
"license": "0000",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FOSTER CARE",
"identifier": "00000",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Show Low, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.