Madison Shanks Bundrum

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-171297 Issued in AL

Practice address

912 Snow St
Oxford, AL 36203-1214

Phone

(256) 237-1001

NPI assigned

Dec 4, 2020

Last updated

Mar 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IDCIBD
• FHIR API: https://fhir4.healow.com/fhir/r4/IDCIBD/Endpoint/IDCIBD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eloubeidi Gastroenterology and Associates Inc

  • Gastroenterology Physician
  • Oxford, AL
  • NPI 1841939592

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1154927218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 BARRINGTON CIR",
            "city": "ALEXANDRIA",
            "state": "AL",
            "postal_code": "362507216",
            "telephone_number": "256-282-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 SNOW ST",
            "city": "OXFORD",
            "state": "AL",
            "postal_code": "362031214",
            "telephone_number": "256-237-1001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1802 6th Ave S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331932",
            "country_code": "US",
            "telephone_number": "205-975-7766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUNDRUM",
        "first_name": "MADISON",
        "middle_name": "SHANKS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-04",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-171297",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-171297",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruno's Supermarkets, LLC. (Food Max Pharmacy #240)
• Kayla Elizabeth Bryars
• Thomes Buchanan
• Annette Funnichello Buggs, LPN
• Sarah Hicks Bullock
• Penny Burcham
• Raleshia Nix Burke, O.D.
• Elizabeth Burson
• John Spotswood Burwell, MD
• Dalton Busby

• Family Nurse Practitioner in Oxford, AL
• Providers in Oxford, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.