Warren Shaeffer

Primary specialty

DentistTaxonomy code 122300000X

License

DN18914 Issued in FL

Practice address

4615 Philips Hwy Ste 3
Jacksonville, FL 32207-9541

Phone

(904) 508-0710

Fax

(855) 299-7010

NPI assigned

Dec 20, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: warren.shaeffer@can.eclinicaldirectplus.com

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

• Can Community Health, Inc.

  • Infectious Disease Physician
  • Sarasota, FL
  • NPI 1104829274

  Dentist

  Medicare reassignment NPD
• Can Community Health Inc.

  • Community/Retail Pharmacy
  • Jacksonville, FL
  • NPI 1538600424
  NPD

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

{
    "created_epoch": "1387497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1033530852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT. #394",
            "address_2": "P.O. BOX 1000",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480001",
            "telephone_number": "941-300-4440",
            "fax_number": "941-404-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 PHILIPS HWY STE 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079541",
            "telephone_number": "904-508-0710",
            "fax_number": "855-299-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAEFFER",
        "first_name": "WARREN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-20",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN18914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael Morrow Shad, APRN
• Elizabeth Burty Shadden, LMHC
• Paige Shadden
• Shades of Autism Parent Network, Inc.
• Michael Shaeffer, DMD
• Willette Shaeffer, DMD
• William Shaeffer, DMD
• Winston Shaeffer, D.M.D.
• Shafer Chiropractic Clinic Inc
• Erich Ernest Shafer, D.C.0

• Dentist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.