NPIMap

Individual provider Active NPI

Shayne R Squires, M.D.

  • Cardiovascular Disease Physician
  • Monroe, GA
National Provider Identifier
1043257090
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
77557 Issued in GA
Practice address
2151 W Spring St Ste B110
Monroe, GA 30655-3209
Phone
(770) 267-1895
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 62453 WI
Nuclear Medicine Physician 207U00000X 34402 IA
Nuclear Medicine Physician 207U00000X 223248 MA
Cardiovascular Disease Physician 207RC0000X 77557 GA Primary

Addresses

Primary practice location

2151 W Spring St Ste B110
Monroe, GA 30655-3209

Mailing address

2727 Paces Ferry Rd SE Ste 1-1100
Atlanta, GA 30339-6151

Other identifiers 1

IdentifierTypeStateIssuer
1043257090MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, MT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220930001579 NC Practitioner - Cardiovascular Disease (Cardiology) 8224012679 Reassigns benefits to 3 organizations
I20250811002082 MT Practitioner - Cardiovascular Disease (Cardiology) 8224012679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Washington School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Peters HealthGroup PAC ID 7911814926, 206 clinicians

Practice addresses (Care Compare)

2550 E Broadway St
Helena, MT 59601-4905
Phone (406) 447-2828

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
77557GAMDCardiovascular Disease Physician
62453WIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Watauga Medical Center Inc Cardiovascular Disease CurrentSince Jul 11, 2022 Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc. Cardiovascular Disease CurrentSince Jul 11, 2022 Accepting new patients
St. Peter's Health CurrentSince Aug 18, 2025 Accepting new patients
Watauga Medical Center, Inc. Current Accepting new patients
St. Peter's Health CurrentSince Aug 18, 2025 Accepting new patients
St Peter's Health Current Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc Current Accepting new patients
Charles a Cannon Jr Memorial Hospital Inc CurrentSince Jul 11, 2022 Accepting new patients
Watauga Medical Center Inc CurrentSince Jul 11, 2022 Accepting new patients
Watauga Medical Center Inc Cardiovascular Disease CurrentSince Jul 11, 2022 Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc. Current Accepting new patients
St. Peter's Health Past Accepting new patients

Locations

2475 E Broadway St
Helena, MT 59601
Phone (406) 442-2480

2550 E Broadway St
Helena, MT 59601
Phone (406) 495-6805

155 Furman Rd
Ste 101
Boone, NC 28607
Phone (828) 262-4111

336 Deerfield Rd
Boone, NC 28607
Phone (828) 263-1211

Interoperability endpoints

  • Direct secure messaging: srsquire@yourcarecommunity.org
  • Direct secure messaging: ssquires1013813@direct.unc.nchie.net

Organizations & group practices 12

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1043257090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 PACES FERRY RD SE STE 1-1100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303396151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 W SPRING ST STE B110",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306553209",
            "telephone_number": "770-267-1895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUIRES",
        "first_name": "SHAYNE",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "62453",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "IA",
            "license": "34402",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "MA",
            "license": "223248",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "77557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043257090",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, GA

Sources for this page

Verify at the official NPI Registry.