Jeffrey M Shadle, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

L9899 Issued in TX

Practice address

4682 McDermott Rd # 100
Plano, TX 75024-7772

Phone

(972) 596-6400

Fax

(972) 867-4766

NPI assigned

Oct 10, 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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: jeffrey.shadle.1@29601.direct.athenahealth.com
• Direct secure messaging: drshadle@jmsmp-tx.direct.office.nextgen.com

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.

• Centerwell Senior Primary Care (TX) PA

  • Internal Medicine Physician
  • Pasadena, TX
  • NPI 1861959298
  Medicare reassignment
• Centerwell Senior Primary Care (TX) PA

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1265252787

  Family Medicine

  NPD
• Centerwell Senior Primary Care (TX) PA

  • Internal Medicine Physician
  • Desoto, TX
  • NPI 1689491581

  Family Medicine

  NPD
• Centerwell Senior Primary Care (TX) PA

  • Internal Medicine Physician
  • Houston, TX
  • NPI 1447717871

  Family Medicine

  NPD (past)
• Lightstar Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Shawnee, OK
  • NPI 1396736872
  NPD (past)

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1386632735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4682 MCDERMOTT RD # 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750247772",
            "telephone_number": "972-596-6400",
            "fax_number": "972-867-4766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4682 MCDERMOTT RD # 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750247772",
            "telephone_number": "972-596-6400",
            "fax_number": "972-867-4766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1332 S Plano Rd Ste 550",
            "address_purpose": "LOCATION",
            "city": "Richardson",
            "state": "TX",
            "postal_code": "750815925",
            "country_code": "US",
            "telephone_number": "469-916-7035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHADLE",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L9899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeffrey.shadle.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1332 S Plano Rd Ste 550",
            "city": "Richardson",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750815925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mariam Shabana
• Mohamed Shabana
• Tawfik A. Shabana, M.D.
• Shaiyad Shabbi, PHARMD
• Shadi Najd LC
• Kyle M Shadle, CRNA
• Shafa Mobile Diagnostic Management Inc
• Stacey M Shafenberg, LPA
• Jordan Shafer
• Linh Shafer, RN

• Family Medicine Physician in Plano, TX
• Providers in Plano, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; 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.