Individual provider Active NPI

Charles Andrew Shiver, D.C.

  • Chiropractor
  • Enterprise, AL
National Provider Identifier
1043388283
Registry record updated Feb 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2041 Issued in AL
Practice address
809 E Lee St Ste a
Enterprise, AL 36330-2072
Phone
(334) 393-9355
Fax
(334) 393-4372
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2041 AL Primary

Addresses

Primary practice location

809 E Lee St Ste a
Enterprise, AL 36330-2072

Mailing address

PO Box 311427
Enterprise, AL 36331-1427
Phone (334) 393-9355

Other identifiers 1

IdentifierTypeStateIssuer
515-54001OtherALBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110307000578 AL Practitioner - Chiropractic 1759353451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

809 E Lee St
Suite a
Enterprise, AL 36330-2072
Phone (334) 393-9355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shiver Chiropractic Clinic, P.C. Chiropractor CurrentSince Aug 25, 2003 Accepting new patients

Locations

809 E Lee St
#A
Enterprise, AL 36330
Phone (334) 393-3955

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297382400000",
    "number": "1043388283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 311427",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363311427",
            "telephone_number": "334-393-9355",
            "fax_number": "334-393-4372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 E LEE ST STE A",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302072",
            "telephone_number": "334-393-9355",
            "fax_number": "334-393-4372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVER",
        "first_name": "CHARLES",
        "middle_name": "ANDREW",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2011-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "2041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "515-54001",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2011; 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.