NPIMap

Organization Active NPI

Joe L Shackelford OD LLC

  • Health Service Clinic/Center
  • Mobile, AL
National Provider Identifier
1215229455
Registry record updated Jun 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
S-421-TA-151 Issued in AL
Legal business name
JOE L SHACKELFORD OD LLC
Practice address
685 Schillinger Rd S
Mobile, AL 36695-8922
Phone
(251) 633-5011
Fax
(251) 633-5394
NPI assigned
May 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2011

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

Authorized official

Name
Dr. Joe L. Shackelford, O.D.NPI 1255468997
Title
Member
Phone
(251) 639-7101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X S-421-TA-151 AL Primary

Addresses

Primary practice location

685 Schillinger Rd S
Mobile, AL 36695-8922

Mailing address

1840 Bradshire Dr
Mobile, AL 36695-3078
Phone (251) 639-7101

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1304640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308700800000",
    "number": "1215229455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 BRADSHIRE DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366953078",
            "telephone_number": "251-639-7101",
            "fax_number": "251-639-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 SCHILLINGER RD S",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366958922",
            "telephone_number": "251-633-5011",
            "fax_number": "251-633-5394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOE L SHACKELFORD OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-06",
        "last_updated": "2011-06-22",
        "status": "A",
        "authorized_official_last_name": "SHACKELFORD",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "251-639-7101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "AL",
            "license": "S-421-TA-151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; 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.