SHANTAI MCDERMOTT (NPI# 1093112898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093112898 |
| Entity Type | Individual |
| Full Name | SHANTAI MCDERMOTT |
| Practice Address |
10130 Perimeter Pkwy Ste 200 Charlotte NC 28216-0197 |
| Practice Telephone | 8888497379 |
| Practice Fax Number | 8558577333 |
| Mailing Telephone | 8888497379 |
| Mailing Fax Number | 8558577333 |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2017-11-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 5009738 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
ARNP9338371 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
ARNP9338371 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9009 Corporate Lake Dr, Suite 200, Tampa, FL 336342367 | 8008258792 |
| Street Address |
10130 PERIMETER PKWY STE 200 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28216-0197 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194718619 | John Michael Shimko | Podiatrist | 10130 Perimeter Pkwy Ste 200, Charlotte, NC 28216-0197 | 2005-08-30 |
| 1932686128 | Misty Moore Reagan | Nurse Practitioner | 10130 Perimeter Pkwy Ste 200, Charlotte, NC 28216 | 2018-07-20 |
| 1093205049 | Khamphou Manivanh Mosley | Nurse Practitioner | 10130 Perimeter Pkwy Ste 200, Charlotte, NC 28216-0197 | 2018-05-15 |
| 1316453194 | Kenya Lakisha Cruz | Nurse Practitioner | 10130 Perimeter Pkwy Ste 200, Charlotte, NC 28216 | 2017-12-15 |
| 1164947305 | Toshia Chipman | Nurse Practitioner | 10130 Perimeter Pkwy Ste 200, Charlotte, NC 28216-0197 | 2017-08-09 |
| 1447774823 | Lakiesha Johnson Squirewell | Nurse Practitioner | 10130 Perimeter Pkwy Ste 200, Charlotte, NC 28216-0197 | 2017-07-27 |
| 1205367588 | Eva Krug | Social Worker | 10130 Perimeter Pkwy Ste 200, Charlotte, NC 28216-0197 | 2017-03-27 |
| 1639626047 | Tiaira Robinson | Social Worker | 10130 Perimeter Pkwy Ste 200, Charlotte, NC 28216-0197 | 2016-09-01 |
| 1396115424 | Michelle Dunlap Deaton | Nurse Practitioner | 10130 Perimeter Pkwy Ste 200, Charlotte, NC 28216-0197 | 2015-10-01 |
| 1629447503 | Cheria Morgan | Social Worker | 10130 Perimeter Pkwy Ste 200, Charlotte, NC 28216 | 2015-09-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942837331 | Transit Consortium of South Carolina, LLC | Non-emergency Medical Transport (VAN) | 5025 Roundstone Way, Suite 103, Charlotte, NC 28216 | 2020-03-25 |
| 1811538796 | Strengthening Families Within Communities LLC | Community/Behavioral Health | 4135 Bryan Furr Drive, Charlotte, NC 28216 | 2019-10-02 |
| 1841705159 | Karen Sue Rhea | Registered Nurse | 4004 Nicole Eileen Lane, Charlotte, ND 28216 | 2017-12-08 |
| 1992225890 | Be Free Counseling, Pllc | Social Worker | 7800 Bridle Court, Charlotte, NC 28216 | 2017-06-21 |
| 1013466416 | Roha Solutions, Inc | Community Based Residential Treatment Facility, Mental Illness | 1529 Jennings St, Charlotte, NC 28216 | 2016-09-26 |
| 1336595826 | North Carolina Neurodiagnostics, LLC | Clinic/Center | 10130 Perimeter Pwky, Ste. 200, Office 250, Charlotte, NC 28216 | 2016-05-13 |
| 1346600699 | Elizabeth Ayodele Agiri | Registered Nurse | 9404 Perimeter Station Dr, Apt. 108, Charlotte, NC 28216 | 2016-02-29 |
| 1922479179 | Prashant Patel | Pharmacist | 9820 Callibridge Court, Charlotte, NC 28216 | 2015-10-14 |
| 1205226685 | Sarah Baker | Social Worker | 10506 Grobie Way Apt 104, Charlotte, NC 28216 | 2015-01-23 |
| 1578967089 | The Moon Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4548 Hyperion Court, Charlotte, NC 28216 | 2014-10-13 |
| Find all providers in zip 28216 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215544986 | Tonya Lynn Burris | Nurse Practitioner | 7810 Providence Rd Ste 102, Charlotte, NC 28226-2987 | 2020-09-28 |
| 1003428293 | Kashari Davis | Nurse Practitioner | 4252 Sutwick Dr, Charlotte, NC 28269-6001 | 2020-08-19 |
| 1457972796 | Lindsey O'brien | Nurse Practitioner | 3423 Hornets Nest Way, Charlotte, NC 28208-5224 | 2020-04-28 |
| 1285254904 | Barbara Ballard | Nurse Practitioner | 10731 Haddington Dr Nw, Charlotte, NC 28269-6954 | 2020-04-22 |
| 1710506787 | Lindsey Delcasino Plair | Nurse Practitioner | 1212 South Blvd, Charlotte, NC 28203-4215 | 2020-04-10 |
| 1457991275 | Advanced Physical Medicine | Nurse Practitioner | 8821 University East Dr # 120, Charlotte, NC 28213-4200 | 2020-01-09 |
| 1700447562 | Milford Darnell George Jr. | Nurse Practitioner | 8403 University Executive Park Drive, Suite 685, Charlotte, NC 28262-3330 | 2019-06-24 |
| 1194288241 | Tonya Denise Farmer | Nurse Practitioner | 620 Tom Hunter Road, Charlotte, NC 28213 | 2019-04-06 |
| 1649738204 | Brittany Schmalfeld | Nurse Practitioner | 8943 S Tryon St Unit K, Charlotte, NC 28273-3539 | 2019-03-03 |
| 1407313703 | Natalie Ann Bullock | Nurse Practitioner | 400 E Stonewall St Ste F, Charlotte, NC 28202-3601 | 2019-02-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.