Individual provider Active NPI

David L Shoemaker, MD

  • Otolaryngology Physician
  • Greensboro, NC
National Provider Identifier
1255386991
Registry record updated Oct 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
34803 Issued in NC
Practice address
1132 N Church St
Suite 200
Greensboro, NC 27401-1039
Phone
(336) 379-9445
Fax
(336) 691-1704
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 34803 NC Primary

Addresses

Primary practice location

1132 N Church St
Suite 200
Greensboro, NC 27401-1039

Mailing address

1132 N Church St
Suite 200
Greensboro, NC 27401-1039
Phone (336) 379-9445

Other identifiers 2

IdentifierTypeStateIssuer
10516OtherNCBCBS
8910516MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041216000065 NC Practitioner - Otolaryngology 1254398712

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17588NCMDMental Health Counselor
34803NCMDOtolaryngology Physician

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256688000000",
    "number": "1255386991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 N CHURCH ST",
            "address_2": "SUITE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011039",
            "telephone_number": "336-379-9445",
            "fax_number": "336-691-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 N CHURCH ST",
            "address_2": "SUITE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011039",
            "telephone_number": "336-379-9445",
            "fax_number": "336-691-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOEMAKER",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2009-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "34803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "10516",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8910516",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.