NPIMap

Individual provider Active NPI

Nancy A Shakin, PA-C

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1992735674
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA02167 Issued in TX
Practice address
7610 W Hwy 71
Ste F
Austin, TX 78735
Phone
(512) 610-5151
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA02167 TX Primary

Addresses

Primary practice location

7610 W Hwy 71
Ste F
Austin, TX 78735

Mailing address

7610 W Hwy 71
Ste F
Austin, TX 78735-8231
Phone (512) 610-5151

Other identifiers 4

IdentifierTypeStateIssuer
181346102MedicaidTX
181346101MedicaidTX
8N8785OtherTXBCBS
1992735674OtherTXBLUE CROSS BLUE SHIELD

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA02167TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
House Call Doctors Texas PLLC Past Accepting new patients
Emcare Iah Emergency Physicians PLLC Past Accepting new patients
Traditions Emergency Medicine PA Past Accepting new patients
Emcare-Dtxemergency Physicians PLLC Physician Assistant Past Accepting new patients
Camino Real Emergency Physicians PLLC Physician Assistant Past Accepting new patients
Southeast Emergency Physician Associates, P.a. Past Accepting new patients

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1992735674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7610 W HWY 71",
            "address_2": "STE F",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787358231",
            "telephone_number": "512-610-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7610 W HWY 71",
            "address_2": "STE F",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78735",
            "telephone_number": "512-610-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKIN",
        "first_name": "NANCY",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181346102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181346101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8N8785",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1992735674",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.