Active NPI
Geletta Philae Shavers
- Clinical Social Worker
- Benton, AR
National Provider Identifier
1093148249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 8360C
- Practice address
- 105 Cox St
Benton, AR 72015-4611 - Phone
- (501) 906-4250
- NPI assigned
- Aug 12, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | AR | ||
| Clinical Social Worker | 1041C0700X | 8360C | AR | Primary |
Addresses
Primary practice location
105 Cox St
Benton, AR 72015-4611
Mailing address
1600 Aldersgate Rd Ste 200
Little Rock, AR 72205-6676
Phone (501) 661-0720
Other practice location 1
4400 Shuffield Dr
Little Rock, AR 72205-7100
Phone (501) 247-3713
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8360C | AR | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
Interoperability endpoints
- gelettashavers@tdh.allscriptsdirect.net
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": "1376265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579651200000",
"number": "1093148249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 ALDERSGATE RD STE 200",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722056676",
"telephone_number": "501-661-0720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 COX ST",
"city": "BENTON",
"state": "AR",
"postal_code": "720154611",
"telephone_number": "501-906-4250"
}
],
"practiceLocations": [
{
"address_1": "4400 Shuffield Dr",
"address_purpose": "LOCATION",
"city": "Little Rock",
"state": "AR",
"postal_code": "722057100",
"country_code": "US",
"telephone_number": "501-247-3713",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHAVERS",
"first_name": "GELETTA",
"middle_name": "PHILAE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-12",
"last_updated": "2020-01-22",
"certification_date": "2020-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "AR",
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AR",
"license": "8360C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benton, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.