Meredith Lynn Shaddix, DO

Key facts

NPI

1154589786

Entity type

Individual (NPI type 1)

Primary specialty

Trauma Surgery Physician 2086S0127X

License

OS13143 (FL)

Practice address

5153 North 9TH Avenue
Suite 305
Pensacola, FL 32504

Phone

(850) 416-6159

Fax

(850) 416-7198

NPI assigned

May 30, 2008

Sex

Female

Sole proprietor

No

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.

• Sacred Heart Health System, Inc. Neurological Surgery Physician · Pensacola, FL · NPI 1902857352
  Medicare reassignment Care Compare group NPD FL

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sacred Heart Health System, Inc. General Acute Care Hospital · Pensacola, FL · NPI 1922032424
  Care Compare affiliation Hospital
• Foley Hospital Company LLC General Acute Care Hospital · Foley, AL · NPI 1053382655
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

General Surgery

Education

Nova Southeastern Univ College of Dental Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sacred Heart Health System, Inc (19 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sacred Heart Hospital Hospital · Pensacola, FL · CCN 100025
• Baldwin Health Hospital · Foley, AL · CCN 010083

Procedures performed for Medicare patients

Medicare participation

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: meredith.knofsky.1@9582.direct.athenahealth.com

Specialties & licenses

Addresses

Other names

• Meredith Lynn Knorsky Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 17, 2016.

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1154589786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5153 NORTH 9TH AVENUE",
            "address_2": "SUITE 305",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32504",
            "telephone_number": "850-416-6159",
            "fax_number": "850-416-7198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5153 NORTH 9TH AVENUE",
            "address_2": "SUITE 305",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32504",
            "telephone_number": "850-416-6159",
            "fax_number": "850-416-7198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADDIX",
        "first_name": "MEREDITH",
        "middle_name": "LYNN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-30",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "FL",
            "license": "OS13143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEREDITH",
            "last_name": "KNORSKY",
            "middle_name": "LYNN",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pensacola, FL

• Sara Scrivner Seuzeneau, APRN
• Seville Allergy and Asthma Center, P.a.
• Georgia Linda Sfanos Capel
• Kevin B Shacket, PSYD
• Kyle Kit Shaddix, MD
• Linda Ruth Shade, C.R.N.A.
• Clayton J Shaeffer, DC
• Nandita A Shah
• Viraj Rajiv Shah
• Zeshan Ali Shakir, MBBS

All providers in Pensacola, FL · Trauma Surgery Physician in Florida