Provider Demographics
NPI:1689475303
Name:SHADE, JAMES EDWARD II
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:EDWARD
Last Name:SHADE
Suffix:II
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9405 TALMADGE RD
Mailing Address - Street 2:
Mailing Address - City:PLATTSMOUTH
Mailing Address - State:NE
Mailing Address - Zip Code:68048-3816
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9405 TALMADGE RD
Practice Address - Street 2:
Practice Address - City:PLATTSMOUTH
Practice Address - State:NE
Practice Address - Zip Code:68048-3816
Practice Address - Country:US
Practice Address - Phone:402-659-6820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician