ERICA SHADE (NPI# 1326652454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326652454 |
| Entity Type | Individual |
| Full Name | ERICA SHADE |
| Practice Address |
601 Martin Luther King Jr. Dr 432 Fl Atkins Building Winston-salem NC 27110 |
| Mailing Address |
4758 Topsail Ln Apt 105 Winston Salem NC 27107-7206 |
| Practice Telephone | 3367503174 |
| Mailing Telephone | 7049148058 |
| Enumeration Date | 2020-09-05 |
| Last Update Date | 2020-09-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
601 MARTIN LUTHER KING JR. DR 432 FL ATKINS BUILDING |
| City | WINSTON-SALEM |
| State | NC |
| Zip Code | 27110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609481472 | Alana Monae Cross | Occupational Therapist | 601 Martin Luther King Jr. Dr, 432 Fl Atkins Building, Winston-salem, NC 27710-0001 | 2020-09-09 |
| 1841804838 | Lisa Hartwell | Occupational Therapist | 601 Martin Luther King Jr. Dr, 432 Fl Atkins Building, Winston-salem, NC 27110 | 2020-09-07 |
| 1003420134 | Rachel Lynn Kwiatkowski | Student in an Organized Health Care Education/Training Program | 601 Martin Luther King Jr. Dr, 432 Fl Atkins Building, Winston-salem, NC 27110-0001 | 2020-09-05 |
| 1093329146 | Isha Lawing | Occupational Therapist | 601 Martin Luther King Jr. Dr, 432 Fl Atkins Building, Winston-salem, NC 27110-0001 | 2020-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801140702 | Dina Vallabh | Speech-Language Pathologist | 155 Baker House Trent Drive, Durham, NC 27110 | 2012-10-31 |
| 1386258432 | Valerie Miller | Student in an Organized Health Care Education/Training Program | 601 Mlk Jr Dr, Winston Salem, NC 27110-0001 | 2020-09-05 |
| 1942814074 | Joyous Hawkins | Student in an Organized Health Care Education/Training Program | 601 S Martin Luther King, Winston Salem, NC 27110-0001 | 2020-09-05 |
| 1306450408 | Katlyn Maiolo | Occupational Therapist | 601 Martin Luther King Jr. Drive, 432 Fl Atkins Building, Winston-salem, NC 27110-0001 | 2020-09-04 |
| 1649884701 | Lila Grafius | Occupational Therapist | 601 Martin Luther King Dr 432 Fl Atkins Building, Winston Salem, NC 27110-0001 | 2020-09-04 |
| 1326652504 | Emily Claire Skoglund | Student in an Organized Health Care Education/Training Program | 601 S Martin Luther King Jr Dr Fl 432, Winston Salem, NC 27110-0001 | 2020-09-03 |
| 1366927659 | Judy Larose Foxworth | Physical Therapist | 601 S Mlk Jr Drive F L Atkins Bldg Rm 333, Winston Salem, NC 27110-0001 | 2018-10-02 |
| 1285138123 | Jessica Um | Occupational Therapist | 601 Martin Luther King Jr Dr, 432 Fl Atkins Building, Winston-salem, NC 27110-0001 | 2018-03-23 |
| 1356427793 | Sharon Ambuske Prybylo | Physical Therapist | 330 Fl Atkins, 601 Mlk Jr. Drive, Winston Salem, NC 27110-0001 | 2006-10-28 |
| 1780658336 | Ether Sims Joe | Nurse Practitioner | W. S. S. U., A. H. Ray Student Health Center, 601 Martin Luther King, Jr., Dr., Winston-salem, NC 27110-0001 | 2006-02-13 |
| Find all providers in zip 27110 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255960241 | Alexandra Marie Balmaceda | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Center Pathology Dept, #1 Medical Center Blvd., Winston-salem, NC 27157 | 2020-04-02 |
| 1255838116 | Taylor Brooks | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Health Graduate Medical Education, Medical Center Boulevard Ground Flr Meads Hall Ste B, Winston-salem, NC 27157-0001 | 2018-04-08 |
| 1982100509 | Dillon James Magalski | Student in an Organized Health Care Education/Training Program | Piedmont Plaza 1, 1920 West First Street, Wake Forest Baptist Medical Center, Winston-salem, NC 27104 | 2018-04-03 |
| 1497259675 | Joseph Hobson Gitt | Student in an Organized Health Care Education/Training Program | 1920 West First Street, Piedmont Plaza I, Winston-salem, NC 27157-1084 | 2018-03-21 |
| 1336643535 | Phillip Martin Kostelic | Student in an Organized Health Care Education/Training Program | Anesthesiology - Wake Forest Baptist Medical Center, 1 Medical Center Blvd, Winston-salem, NC 27157 | 2018-03-21 |
| 1831693324 | Aleah Bond | Student in an Organized Health Care Education/Training Program | Anesthesiology Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-salem, NC 27157 | 2018-03-20 |
| 1164950804 | Donald Joyce | Student in an Organized Health Care Education/Training Program | 1920 West First St, Piedmont Plaza I Building, 3rd Floor, Winston-salem, NC 27104 | 2017-05-25 |
| 1023467529 | Edward John Doyle IIi | Student in an Organized Health Care Education/Training Program | Wake Forest School of Medicine Dept. of Otolaryngology, Watlington Hall 4th Fl. Medical Center Boulevard, Winston-salem, NC 27157 | 2016-06-07 |
| 1477917888 | Jordan Mae Burner | Student in an Organized Health Care Education/Training Program | Graduate Medical Education Office, Wake Forest Baptist Medical Center, Medical Center Blvd, Winston-salem, NC 27157 | 2016-04-12 |
| 1548680366 | Thomas Elliott Pendergrast | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Center, Medical Center Blvd., Winston-salem, NC 27157 | 2014-04-19 |
| Find all providers in WINSTON-SALEM | ||||
| City | WINSTON-SALEM |
| Zip Code | 27110 |
Please comment or provide details below to improve the information on ERICA SHADE.
| 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.