Individual provider Active NPI

Kiumars E. Shams, M.D.

  • Psychiatry Physician
  • Graceville, FL
National Provider Identifier
1386780302
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME29949 Issued in FL
Practice address
5389 Cotton St
Graceville, FL 32440-1739
Phone
(850) 360-4147
Fax
(850) 360-4068
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME29949 FL
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X ME29949 FL
Psychiatry Physician 2084P0800X ME29949 FL Primary

Addresses

Primary practice location

5389 Cotton St
Graceville, FL 32440-1739

Mailing address

PO Box 186
Graceville, FL 32440-0186
Phone (850) 360-4147

Other practice location 1

4400 Bayou Blvd Ste 8
Pensacola, FL 32503-1908
Phone (850) 474-9882

Other identifiers 3

IdentifierTypeStateIssuer
038295700MedicaidFL
582678372OtherFLTRICARE
79178OtherFLBCBS FL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kelly Stone Counseling LLC PastSince Mar 24, 2024 Accepting new patients
Bingham-Turner and Associates Inc PastSince May 7, 2026 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1386780302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 186",
            "city": "GRACEVILLE",
            "state": "FL",
            "postal_code": "324400186",
            "telephone_number": "850-360-4147",
            "fax_number": "850-360-4068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5389 COTTON ST",
            "city": "GRACEVILLE",
            "state": "FL",
            "postal_code": "324401739",
            "telephone_number": "850-360-4147",
            "fax_number": "850-360-4068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4400 Bayou Blvd Ste 8",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325031908",
            "country_code": "US",
            "telephone_number": "850-474-9882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAMS",
        "first_name": "KIUMARS",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME29949",
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "FL",
            "license": "ME29949",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME29949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038295700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "582678372",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "79178",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Graceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.