Shane Christopher Masters, M.D. PH.D. PHARM.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

2011-00703 Issued in NC

Practice address

Wfuhs Department of Radiology
Medical Center Blvd
Winston Salem, NC 27157-0001

Phone

(336) 716-2255

Fax

(336) 716-3202

NPI assigned

Dec 21, 2007

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy, Doctor of Pharmacy

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351814400000",
    "number": "1053595439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602658",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WFUHS DEPARTMENT OF RADIOLOGY",
            "address_2": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2255",
            "fax_number": "336-716-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERS",
        "first_name": "SHANE",
        "middle_name": "CHRISTOPHER",
        "credential": "M.D. PH.D. PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-21",
        "last_updated": "2012-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2011-00703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q03011",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810023022",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5920599",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William T. Mason, MD
• Charles Frank Massler Jr., D.D.S.
• Brooke Miller Masten, PHARMD
• Carolyn Masters
• David Lee Masters, M.D.
• Christine Ann Mastic, CRNA
• Katherine Martin Matador, M.A. CCC-SLP
• Charlotte Ann Matheny, RPH
• Elise Kay Marvin Mather
• Jacob Matherly

• Diagnostic Radiology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Diagnostic Radiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.