Active NPI
Shandi Lynne Damron
- Clinical Social Worker
- Princeton, KY
National Provider Identifier
1932309697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6644
- Practice address
- 1350 US Highway 62 W
Princeton, KY 42445 - Phone
- (270) 365-2008
- Fax
- (270) 365-2009
- NPI assigned
- Jul 20, 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6644 | KY | Primary |
Addresses
Primary practice location
1350 US Highway 62 W
Princeton, KY 42445
Mailing address
PO Box 614
Hopkinsville, KY 42241-0614
Phone (270) 886-2205
Other practice location 1
3025 Clay St
Paducah, KY 42001-4071
Phone (270) 443-1317
Other practice location 2
735 North Dr
Hopkinsville, KY 42240-2620
Phone (270) 886-5163
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6644 | KY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539648000000",
"number": "1932309697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 614",
"city": "HOPKINSVILLE",
"state": "KY",
"postal_code": "422410614",
"telephone_number": "270-886-2205",
"fax_number": "270-886-0392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 US HIGHWAY 62 W",
"city": "PRINCETON",
"state": "KY",
"postal_code": "42445",
"telephone_number": "270-365-2008",
"fax_number": "270-365-2009"
}
],
"practiceLocations": [
{
"address_1": "3025 Clay St",
"address_purpose": "LOCATION",
"city": "Paducah",
"state": "KY",
"postal_code": "420014071",
"country_code": "US",
"telephone_number": "270-443-1317",
"fax_number": "270-443-1369",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "735 North Dr",
"address_purpose": "LOCATION",
"city": "Hopkinsville",
"state": "KY",
"postal_code": "422402620",
"country_code": "US",
"telephone_number": "270-886-5163",
"fax_number": "270-886-5178",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAMRON",
"first_name": "SHANDI",
"middle_name": "LYNNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-20",
"last_updated": "2018-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "6644",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Princeton, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.