Shakira Anderson

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Practice address

4080 E Lake Mead Blvd Ste B-111
Las Vegas, NV 89115-6466

Phone

(702) 531-9344

NPI assigned

Jan 26, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

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.

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1962093609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4080 E LAKE MEAD BLVD STE B-111",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891156466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 E LAKE MEAD BLVD STE B-111",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891156466",
            "telephone_number": "702-531-9344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SHAKIRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-26",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7026298226",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "7257103859",
            "affiliation": "N",
            "address_1": "4080 E Lake Mead Blvd Ste B-111",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891156466",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "7257103859",
            "affiliation": "N",
            "address_1": "4080 E Lake Mead Blvd Ste B-111",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891156466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Renise Anderson
• Rivka Anderson, OTR/L
• Robert Patrick Anderson
• Samaya Anderson
• Sean Anderson
• Shantel Anderson
• Shavon Anderson
• Sheri D Anderson, MHA/ED,.LADC
• Sondra Anderson
• Sydney K Anderson, RBT

• In Home Supportive Care Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• In Home Supportive Care Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.