Individual provider Active NPI

Shawn Hansberry, M.D.

  • Anesthesiology Physician
  • Durham, NC
National Provider Identifier
1316230550
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A142238 Issued in CA
Practice address
2301 Erwin Road
Durham, NC 27710
Phone
(919) 684-8111
NPI assigned
May 20, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X A142238 CA Primary

Addresses

Primary practice location

2301 Erwin Road
Durham, NC 27710

Mailing address

2301 Erwin Road
Durham, NC 27710
Phone (919) 684-8111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160613000243 CA Practitioner - Anesthesiology 2466742903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Tufts University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newport Harbor Anesthesia Consultants Medical Group IncGroup PAC ID 1759284771, 86 clinicians

Practice addresses (Care Compare)

1 Hoag Dr
Newport Beach, CA 92663-4162
Phone (949) 645-8600

Hospital & facility affiliations

  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224
  • Hoag Orthopedic Institute Hospital, Irvine, CA, CCN 050769

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A142238CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newport Harbor Anesthesia Consultants Medical Group Inc Anesthesiology CurrentSince Jul 12, 2016 Accepting new patients

Locations

351 Hospital Rd
Ste 420
Newport Beach, CA 92663
Phone (949) 631-7900

1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1305849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469491200000",
    "number": "1316230550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 ERWIN ROAD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27710",
            "telephone_number": "919-684-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 ERWIN ROAD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27710",
            "telephone_number": "919-684-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSBERRY",
        "first_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-20",
        "last_updated": "2016-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A142238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.