Active NPI
Shanacia Tyiska
- Registered Nurse
- Longview, TX
National Provider Identifier
1912568775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 879044
- Practice address
- 308 Meadowlark LN
Longview, TX 75603-7627 - Phone
- (903) 736-9689
- NPI assigned
- Jun 24, 2019
- Last updated
- Jun 24, 2019
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 879044 | TX | Primary |
Addresses
Primary practice location
308 Meadowlark LN
Longview, TX 75603-7627
Mailing address
308 Meadowlark LN
Longview, TX 75603-7627
Phone (903) 736-9689
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 |
|---|---|---|---|
| 879044 | TX | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561334400000",
"number": "1912568775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 MEADOWLARK LN",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756037627",
"telephone_number": "903-736-9689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 MEADOWLARK LN",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756037627",
"telephone_number": "903-736-9689"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYISKA",
"first_name": "SHANACIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-24",
"last_updated": "2019-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TX",
"license": "879044",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longview, TX
- Shauna Turner
- Tiffany John'Nie Turner, MD
- Marcus Dale Turney, RN, FNP-C
- Twelve52 Wellness Clinic (Twelve52 Clinic)
- Tiffany Tyeskie, FNP-C
- U First Physical Therapy and Wellness PLLC
- Adelaido Parilla Ubalde Jr., PT
- Jeanne Marie Santos Ubalde, PT, CLT
- Michelle Uhlir, RT (R)
- Ultra Orthodontics (Burson Orthodontics)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.