Shenna Michelle Clyburn

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Practice address

3112 Delaware Ave
Fort Pierce, FL 34947-3531

Phone

(772) 666-0672

NPI assigned

Oct 8, 2020

Last updated

Oct 8, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1871190157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3112 DELAWARE AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349473531",
            "telephone_number": "772-666-0672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3112 DELAWARE AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349473531",
            "telephone_number": "772-666-0672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYBURN",
        "first_name": "SHENNA",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Ann Clegg, MA,,LMHC
• George Francis Clemens, DC
• Sonya Lanette Clemons-Baird, RN
• Kristelle Alie Clemons, FNP
• Julie Diane Clute, ARNP
• CMS Ft. Pierce
• Coastal Drip Mobile IV
• Coastal Quality Assisted Living, LLC
• Coastal Wellness and Physiotherapy, LLC
• Daniel Cobbina

• Adult Day Care Clinic/Center in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Adult Day Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.