Vernon C. Shaffer Jr., MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

G6012 Issued in TX

Practice address

2604 Saint Michael Dr
Suite 410
Texarkana, TX 75503-2379

Phone

(903) 614-5430

Fax

(903) 614-5464

NPI assigned

Dec 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483315200000",
    "number": "1265419030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 HIDDEN RDG",
            "address_2": "6TH FLOOR",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383813",
            "telephone_number": "469-282-2711",
            "fax_number": "469-282-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 SAINT MICHAEL DR",
            "address_2": "SUITE 410",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032379",
            "telephone_number": "903-614-5430",
            "fax_number": "903-614-5464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "VERNON",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2017-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "G6012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110879001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124647205",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124647202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• James Higdon Shambarger, D.D.S, M.S.
• Sandra Lynn Shambarger, DDS
• Roshan L Sharma, M.D.
• Kristy Sharp, COTA/L
• Richard B Sharp, MD

• Obstetrics & Gynecology Physician in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2017; 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.