Carson Shearer, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

5339 Issued in OK

Practice address

20 12TH Ave NW
Ardmore, OK 73401-5722

Phone

(580) 223-3411

Fax

(580) 226-6213

NPI assigned

Feb 18, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 11, 2018 through Apr 11, 2028

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Essential Health & Wellness

  • Primary Care Clinic/Center
  • Cary, NC
  • NPI 1467990234
  NPD (past)

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1093037087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 12TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734015722",
            "telephone_number": "580-223-3411",
            "fax_number": "580-226-6213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 12TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734015722",
            "telephone_number": "580-223-3411",
            "fax_number": "580-226-6213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEARER",
        "first_name": "CARSON",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-18",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "5339",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OK",
            "license": "5339",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200494610A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mahmoud Shadi, M.D.
• Rachel Shaffer
• Bhavin C Shah, MD
• Bryan Eliot Shapiro, M.D.
• Mark Alan Sheaman, PAC
• Alissa G Shelby
• Natosha Shelton
• Tausha Zann Shelton, ARNP-CNP
• Nathaniel Leif Shepard
• Ajae Shepherd

• Internal Medicine Physician in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.