Provider Demographics
NPI:1063215879
Name:THOMPSON, SHAVIKA
Entity type:Individual
Prefix:
First Name:SHAVIKA
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 QUIET CT
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23701-3618
Mailing Address - Country:US
Mailing Address - Phone:757-799-7720
Mailing Address - Fax:
Practice Address - Street 1:1412 QUIET CT
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23701-3618
Practice Address - Country:US
Practice Address - Phone:757-239-7336
Practice Address - Fax:757-558-1824
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)