Individual provider Active NPI

Shabnam Guard, M.D.

  • Family Medicine Physician
  • Montgomery, AL
National Provider Identifier
1255594479
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MT193956 Issued in PA
Practice address
1845 Cherry St
Montgomery, AL 36107-2613
Phone
(334) 420-5001
Fax
(334) 420-0160
NPI assigned
Jul 8, 2008
Last updated
Oct 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MT193956 PA Primary

Addresses

Primary practice location

1845 Cherry St
Montgomery, AL 36107-2613

Mailing address

500 University Dr
Hershey, PA 17033-2360
Phone (717) 531-8521

Other practice location 1

500 University Dr
Hershey, PA 17033-2360
Phone (717) 531-8521

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160328000234 AL Practitioner - Family Practice 7618274226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Services IncGroup PAC ID 1557324811, 30 clinicians

Practice addresses (Care Compare)

1845 Cherry St
Montgomery, AL 36107-2613
Phone (334) 420-5001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT193956PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Services, Inc. CurrentSince Feb 23, 2016 Accepting new patients
Health Services Inc CurrentSince Feb 23, 2016 Accepting new patients
Health Services Inc Past Accepting new patients

Locations

107 Medical Center Dr
Clanton, AL 35045
Phone (205) 280-1478

511 E Tuskeena St
Hayneville, AL 36040
Phone (334) 548-2516

Interoperability endpoints

  • Direct secure messaging: shabnam.guard.1@14429.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1255594479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "717-531-8521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 CHERRY ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361072613",
            "telephone_number": "334-420-5001",
            "fax_number": "334-420-0160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "717-531-8521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUARD",
        "first_name": "SHABNAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT193956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.