Kimalisa Kay Shamblin, BA, RT(R)(CT), RVT

Primary specialty

Computed Tomography Radiologic TechnologistTaxonomy code 2471C3401X

License

1540 Issued in WV

Practice address

428 Division St
South Charleston, WV 25309-1469

Phone

(304) 766-9617

NPI assigned

Jan 25, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

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

{
    "created_epoch": "1295913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295913600000",
    "number": "1982909800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 WILDLIFE WAY",
            "city": "CLENDENIN",
            "state": "WV",
            "postal_code": "250455193",
            "telephone_number": "304-206-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 DIVISION ST",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091469",
            "telephone_number": "304-766-9617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMBLIN",
        "first_name": "KIMALISA",
        "middle_name": "KAY",
        "credential": "BA, RT(R)(CT), RVT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-25",
        "last_updated": "2011-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246XS1301X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist Cardiovascular, Sonography",
            "state": "WV",
            "license": "1540",
            "primary": false
        },
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "WV",
            "license": "1540",
            "primary": false
        },
        {
            "code": "2471C3401X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Computed Tomography",
            "state": "WV",
            "license": "1540",
            "primary": true
        },
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "WV",
            "license": "1540",
            "primary": false
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "WV",
            "license": "1540",
            "primary": false
        },
        {
            "code": "2471V0105X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": "WV",
            "license": "1540",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisha Shaffer
• Janis Shaffer
• Jasmine Shaffer
• Lauren Shaffer
• Virginia Shahan
• Tyler Shamblin, DPT
• Bassam Nicholas Shamma, MD
• Stephanie Shamma, APRN, MSN FNP-BC.
• Melissa Shaw
• Margie Shawver

• Radiologic Technologist in South Charleston, WV
• Providers in South Charleston, WV by specialty
• Radiologic Technologist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.