Individual provider Active NPI

Shade Celestine

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1932733615
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
293 East53Rd Street
Brooklyn, NY 11203
Phone
(646) 464-5229
NPI assigned
Mar 3, 2020
Last updated
Mar 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

293 East53Rd Street
Brooklyn, NY 11203

Mailing address

293 E 53Rd St
Brooklyn, NY 11203-3605

Other practice location 1

293 E 53rd St
Brooklyn, NY 11203-3605
Phone (347) 702-7294

Other practice location 2

293 E 53rd St
Brooklyn, NY 11203-3605
Phone (646) 464-5229

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address therapy@wonderworldcenter.com Other
Direct Messaging Address therapy@wonderworldcenter.com

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

NPI Registry JSON

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1932733615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "293 E 53RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112033605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 EAST53RD STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11203",
            "telephone_number": "646-464-5229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "293 E 53rd St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112033605",
            "country_code": "US",
            "telephone_number": "347-702-7294",
            "fax_number": "718-676-6014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "293 E 53rd St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112033605",
            "country_code": "US",
            "telephone_number": "646-464-5229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CELESTINE",
        "first_name": "SHADE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-03",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "therapy@wonderworldcenter.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "communiication",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "messages",
            "address_1": "293 E 53rd St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112033605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "therapy@wonderworldcenter.com",
            "affiliation": "N",
            "address_1": "293 E 53rd St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112033605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.