Individual provider Active NPI

Shawntral Maria Julia Brimm

  • Home Health Agency
  • Bluffton, SC
National Provider Identifier
1962011874
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Practice address
110 Traders Cross # 107
Bluffton, SC 29909-4637
Phone
(843) 227-6135
NPI assigned
Jul 27, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

110 Traders Cross # 107
Bluffton, SC 29909-4637

Mailing address

186 Rolling Marsh LN Unit 206
Hardeeville, SC 29927-2754
Phone (843) 227-3165

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": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1962011874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 ROLLING MARSH LN UNIT 206",
            "city": "HARDEEVILLE",
            "state": "SC",
            "postal_code": "299272754",
            "telephone_number": "843-227-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 TRADERS CROSS # 107",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299094637",
            "telephone_number": "843-227-6135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIMM",
        "first_name": "SHAWNTRAL",
        "middle_name": "MARIA JULIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.