Individual provider Active NPI

James E. Shearer, M.D.

  • Diagnostic Radiology Physician
  • Fayetteville, NC
National Provider Identifier
1053316638
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
38436 Issued in NC
Practice address
3186 Village Dr 201
Fayetteville, NC 28304-3979
Phone
(910) 486-5700
Fax
(910) 486-5950
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 38436 NC Primary

Addresses

Primary practice location

3186 Village Dr 201
Fayetteville, NC 28304-3979

Mailing address

3186 Village Dr 201
Fayetteville, NC 28304-3979
Phone (910) 486-5700

Other identifiers 1

IdentifierTypeStateIssuer
8975582MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090603000537 NC Practitioner - Diagnostic Radiology 8820179922 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38436NCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bladen Healthcare, LLC CurrentSince Aug 16, 2015 Accepting new patients
Valley Radiology P a Diagnostic Radiology CurrentSince Oct 2, 1989 Accepting new patients
Bladen Healthcare LLC CurrentSince Aug 16, 2015 Accepting new patients
Bladen Healthcare LLC Current Accepting new patients

Locations

501 S Poplar St
Elizabethtown, NC 28337
Phone (910) 862-4043

3186 Village Dr
Ste 201
Fayetteville, NC 28304
Phone 9104865700104

Organizations & group practices 4

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": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1053316638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3186 VILLAGE DR 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043979",
            "telephone_number": "910-486-5700",
            "fax_number": "910-486-5950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3186 VILLAGE DR 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043979",
            "telephone_number": "910-486-5700",
            "fax_number": "910-486-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEARER",
        "first_name": "JAMES",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "38436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8975582",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.