Brian Charles Shiro, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

30859 Issued in NC

Practice address

1915 S 17TH St
Suite 100
Wilmington, NC 28401-6681

Phone

(910) 362-9511

NPI assigned

Oct 12, 2005

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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217376000000",
    "number": "1093703175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20169",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240180506",
            "telephone_number": "540-767-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 S 17TH ST",
            "address_2": "SUITE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016681",
            "telephone_number": "910-362-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRO",
        "first_name": "BRIAN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2008-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "30859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "75966",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8975966",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "220012149",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q30859",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laken Kiana Shingleton, LCSWA
• Melissa Faith Game Shipley, M.D.
• Shipyard Medical Center
• Anne Gillies Shirk, RBT
• Julia Ann Shirley, PT
• Tiffany W Shivar, LCSWA
• Nadine Shivers, FNP-C
• Shawna Lea Shockey, M.P.T.
• Kayla Shockley
• -Deborah Marvene Shoemaker, MAAT-ATR-BC,LPC

• Anatomic Pathology & Clinical Pathology Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Anatomic Pathology & Clinical Pathology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.