Shatavia M Adams, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

333164 Issued in NY

Practice address

119 Campbell Rd
Syracuse, NY 13211-1203

Phone

(680) 214-9435

NPI assigned

May 22, 2024

Sex

Female

Sole proprietor

Yes

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, last updated by the provider on Jun 7, 2024.

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1891534483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 CAMPBELL RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132111203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 CAMPBELL RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132111203",
            "telephone_number": "680-214-9435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "SHATAVIA",
        "middle_name": "M",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "333164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aisha Adams
• Christina Elizabeth Adams, RN, NP
• Ebony L Adams, LPN
• Laura Adams, MD
• Natasha Adams
• Shicoren M Adams I, YPA CREDIENTIAL
• Taylor Catherine Adams, PT,DPT
• Stacey Adamy, LPN
• Patrick Randall Adcock, M.D.
• Beverly J Addison, NP

• All providers in Syracuse, NY
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.