Richard Wilson Shamblin, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

11910 Issued in AL

Practice address

100 Rice Mine Rd N
Suite B
Tuscaloosa, AL 35406-2300

Phone

(205) 349-4200

Fax

(205) 349-4285

NPI assigned

Aug 29, 2006

Last updated

Dec 16, 2010By the provider in NPPES

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 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: richard.shamblin.1@17862.direct.athenahealth.com

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.

• DCH Provider Services, LLC

  dba North Harbor Psychiatrists

  • Psychiatry Physician
  • Northport, AL
  • NPI 1831480797
  NPD
• Internal Medicine Associates of Tuscaloosa, P.C.

  dba Novus TMS Imat

  • Neurology Physician
  • Tuscaloosa, AL
  • NPI 1598414880
  NPD

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1356450183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RICE MINE RD N",
            "address_2": "SUITE B",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062300",
            "telephone_number": "205-349-4200",
            "fax_number": "205-349-4285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RICE MINE RD N",
            "address_2": "SUITE B",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062300",
            "telephone_number": "205-349-4200",
            "fax_number": "205-349-4285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMBLIN",
        "first_name": "RICHARD",
        "middle_name": "WILSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "11910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528502230",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBER",
            "identifier": "51014598",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Calvin Shadwrick Jr., CRNA
• Amit K Shah, M.D.
• Neil Kirit Shah, M.D.
• Stephanie Kay McWhorter Shah, CRNA
• Andrew Martin Shaheen
• Tonya D Shanahan
• Gaurav Sharma, MD
• Vishal Arjuna Sharma, MD
• Seth Adam Shaul
• Marsha Diane Shaw, CRNP

• Internal Medicine Physician in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.