Shatara Myrie, CNA

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

2620 Meadowsweet Dr
Waldorf, MD 20601-2627

Phone

(216) 375-0935

NPI assigned

Jul 19, 2021

Last updated

Jan 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1982277810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 POWHATAN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212161831",
            "telephone_number": "216-375-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 MEADOWSWEET DR",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206012627",
            "telephone_number": "216-375-0935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYRIE",
        "first_name": "SHATARA",
        "credential": "CNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "402015151017",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "MI",
            "license": "MIOH0056720R",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "laptop",
            "affiliation": "N",
            "endpointDescription": "its primary location  on home office",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "primary. location",
            "address_1": "2620 Meadowsweet Dr",
            "city": "Waldorf",
            "state": "MD",
            "country_code": "US",
            "postal_code": "206012627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Behavior Technician in Waldorf, MD
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• Behavior Technician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.