Individual provider Active NPI

Devin Matthew Shea, D.C.

  • Chiropractor
  • Poway, CA
National Provider Identifier
1033361092
Registry record updated Apr 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC31049 Issued in CA
Practice address
13526 Poway Rd.
Poway, CA 92064
Phone
(858) 668-1700
Fax
(858) 513-4614
NPI assigned
Oct 21, 2008
Last updated
Apr 9, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC31049 CA Primary
Chiropractor 111N00000X 31049 CA

Addresses

Primary practice location

13526 Poway Rd.
Poway, CA 92064

Mailing address

13526 Poway Rd.
Poway, CA 92064
Phone (858) 668-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081210000484 CA Practitioner - Chiropractic 0547321408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11770 Bernardo Plaza CT
Suite 351
San Diego, CA 92128-2426
Phone (858) 312-5066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31049CAMDMarriage & Family Therapist
DC31049CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Shea Family Chiropractic Apc CurrentSince Mar 4, 2019 Accepting new patients
Bernardo West Chiropractic Apc Chiropractor CurrentSince Apr 3, 2023 Accepting new patients

Locations

11770 Bernardo Plaza Ct
Ste 351
San Diego, CA 92128
Phone (858) 312-5066

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239235200000",
    "number": "1033361092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13526 POWAY RD.",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "92064",
            "telephone_number": "858-668-1700",
            "fax_number": "858-513-4614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13526 POWAY RD.",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "92064",
            "telephone_number": "858-668-1700",
            "fax_number": "858-513-4614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEA",
        "first_name": "DEVIN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-21",
        "last_updated": "2009-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC31049",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "31049",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.