Active NPI
Shamiso Mucherera, LAC
- Acupuncturist
- Holly Hill, FL
National Provider Identifier
1891459988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 4254
- Practice address
- 101 2ND St Ste 302
Holly Hill, FL 32117-4903 - Phone
- (386) 677-5400
- NPI assigned
- Oct 26, 2021
- 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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 4254 | FL | Primary |
Addresses
Primary practice location
101 2ND St Ste 302
Holly Hill, FL 32117-4903
Mailing address
1012 McDaniel Creek CT
Oviedo, FL 32765-5714
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 |
|---|---|---|---|
| 4254 | FL | MD | Assistant Behavior Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635206400000",
"number": "1891459988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1012 MCDANIEL CREEK CT",
"city": "OVIEDO",
"state": "FL",
"postal_code": "327655714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 2ND ST STE 302",
"city": "HOLLY HILL",
"state": "FL",
"postal_code": "321174903",
"telephone_number": "386-677-5400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUCHERERA",
"first_name": "SHAMISO",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-26",
"last_updated": "2021-10-26",
"certification_date": "2021-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "FL",
"license": "4254",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holly Hill, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.