Shoals Surgical Group LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

SHOALS SURGICAL GROUP LLC

Practice address

1100 S Jackson Hwy Ste 101
Sheffield, AL 35660-5769

Phone

(256) 772-6018

Fax

(256) 383-0922

NPI assigned

Apr 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. William A Collignon Jr., M.D.NPI 1174587257

Title

President

Phone

(256) 383-0423

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 2

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

• William A Collignon Jr., M.D.

  • Surgery Physician
  • Florence, AL
  • NPI 1174587257
  Medicare reassignment NPD Authorized official
• Shelby Kint Bailey, M.D.

  • Surgery Physician
  • Florence, AL
  • NPI 1801850995
  Medicare reassignment NPD

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1124082789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S JACKSON HWY STE 101",
            "city": "SHEFFIELD",
            "state": "AL",
            "postal_code": "356605769",
            "telephone_number": "256-772-6018",
            "fax_number": "256-383-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S JACKSON HWY STE 101",
            "city": "SHEFFIELD",
            "state": "AL",
            "postal_code": "356605769",
            "telephone_number": "256-772-6018",
            "fax_number": "256-383-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOALS SURGICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-12",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "COLLIGNON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-383-0423",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529926510",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shoals Gastroenterology LLC
• Shoals Medical Group, LLC
• Shoals Medical Trials, Inc.
• Shoals Pathology Services, LLC
• Shoals Primary Care, LLC
• Shoals Urological Associates PC
• Mohammad Siddique, M.D.
• Heidi Leeanne Slappey, CRNP
• Melissa Gayle Sledge, LMT
• Mark Walker Smith, M.D.

• Surgery Physician in Sheffield, AL
• Providers in Sheffield, AL by specialty
• Surgery Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.