NPIMap

Individual provider Active NPI

Shea Taylor

  • Orthopaedic Surgery Physician
  • Lebanon, NH
National Provider Identifier
1407388747
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
22826 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone
(603) 650-5000
NPI assigned
Mar 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 22826 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-1000

Mailing address

15610 Morning Dr
Lutz, FL 33559-3276
Phone (727) 389-9100

Other practice location 1

17 Davis Blvd Ste 308
Tampa, FL 33606-3438
Phone (813) 253-2068

Other practice location 2

10 Alice Peck Day Dr
Lebanon, NH 03766-2900
Phone (603) 448-3121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230613000054 AL Practitioner - Orthopedic Surgery 0648653808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of South Florida College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
S.B.J.S. PCGroup PAC ID 8527043421, 39 clinicians

Practice addresses (Care Compare)

1500 Ross Clark Cir
Dothan, AL 36301-4754
Phone (334) 793-2663

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Dothan, AL, CCN 017164
  • Enhabit Home Health Home health agency, Dothan, AL, CCN 017053
  • Amedisys Home Health Home health agency, Dothan, AL, CCN 017159
  • Southeast Alabama Homecare Home health agency, Dothan, AL, CCN 017024
  • Centerwell Home Health Home health agency, Geneva, AL, CCN 017048
  • Flowers Hospital Hospital, Dothan, AL, CCN 010055
  • Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001
  • Wiregrass Medical Center Hospital, Geneva, AL, CCN 011309
  • Dale Medical Center Hospital, Ozark, AL, CCN 010021
  • Jackson Hospital Hospital, Marianna, FL, CCN 100142

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement84
Knee replacement82
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
S.B.J.S. PC Orthopaedic Surgery CurrentSince Aug 1, 2023 Accepting new patients
SBJS PC Orthopaedic Surgery CurrentSince Aug 1, 2023 Accepting new patients
Triad of Alabama LLC Past Accepting new patients
S.B.J.S. PC Orthopaedic Surgery Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1500 Ross Clark Cir
Dothan, AL 36301
Phone (334) 793-2663

345 Healthwest Dr
Dothan, AL 36303
Phone (334) 793-2663

2126 W Roy Parker Rd
Ste 201
Ozark, AL 36360
Phone (334) 445-2663

Interoperability endpoints

  • Direct secure messaging: shea.taylor.1@15455.direct.athenahealth.com

Organizations & group practices 5

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 10

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": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1407388747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15610 MORNING DR",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335593276",
            "telephone_number": "727-389-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 Davis Blvd Ste 308",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063438",
            "country_code": "US",
            "telephone_number": "813-253-2068",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Alice Peck Day Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037662900",
            "country_code": "US",
            "telephone_number": "603-448-3121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "SHEA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-28",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NH",
            "license": "22826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.