Organization Active NPI

Safwan Shams,M.D.,P.a.

  • Medical Specialty Clinic/Center
  • Palm Coast, FL
National Provider Identifier
1093860199
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
ME036504 Issued in FL
Legal business name
SAFWAN SHAMS,M.D.,P.A.
Practice address
61 Memorial Medical Pkwy
Suite 1-800a
Palm Coast, FL 32164-5981
Phone
(386) 586-1810
Fax
(386) 586-1811
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Safwan Shams, M.D.NPI 1316970205
Title
President
Phone
(386) 586-1810

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME036504 FL
Medical Specialty Clinic/Center 261QM2500X ME036504 FL Primary

Addresses

Primary practice location

61 Memorial Medical Pkwy
Suite 1-800a
Palm Coast, FL 32164-5981

Mailing address

PO Box 883
Bunnell, FL 32110-0883
Phone (386) 586-1810

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1093860199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 883",
            "city": "BUNNELL",
            "state": "FL",
            "postal_code": "321100883",
            "telephone_number": "386-586-1810",
            "fax_number": "386-586-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 MEMORIAL MEDICAL PKWY",
            "address_2": "SUITE 1-800A",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645981",
            "telephone_number": "386-586-1810",
            "fax_number": "386-586-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFWAN SHAMS,M.D.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "SHAMS",
        "authorized_official_first_name": "SAFWAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-586-1810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME036504",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "ME036504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.