Active NPI
Sandra R Shavers, NP
- Family Medicine Physician
- Mobile, AL
National Provider Identifier
1245967413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 1-096584
- Practice address
- 1303 Dr Martin L King Jr Ave
Mobile, AL 36603-5341 - Phone
- (251) 432-4117
- NPI assigned
- Aug 6, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1-096584 | AL | Primary |
Addresses
Primary practice location
1303 Dr Martin L King Jr Ave
Mobile, AL 36603-5341
Mailing address
6700 Wall St Apt 2J
Mobile, AL 36695-4521
Phone (334) 549-0554
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-096584 | AL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659744000000",
"number": "1245967413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6700 WALL ST APT 2J",
"city": "MOBILE",
"state": "AL",
"postal_code": "366954521",
"telephone_number": "334-549-0554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1303 DR MARTIN L KING JR AVE",
"city": "MOBILE",
"state": "AL",
"postal_code": "366035341",
"telephone_number": "251-432-4117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAVERS",
"first_name": "SANDRA",
"middle_name": "R",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-06",
"last_updated": "2022-08-06",
"certification_date": "2022-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AL",
"license": "1-096584",
"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 Aug 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.