Individual provider Active NPI

Paul R Shook, MD

  • Anesthesiology Physician
  • Charlotte, NC
National Provider Identifier
1427043470
Registry record updated Oct 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
200400261 Issued in NC
Practice address
200 Providence Rd
Suite 101
Charlotte, NC 28207-1468
Phone
(704) 749-5800
Fax
(704) 749-5819
NPI assigned
Sep 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 200400261 NC Primary

Addresses

Primary practice location

200 Providence Rd
Suite 101
Charlotte, NC 28207-1468

Mailing address

200 Providence Rd
Suite 101
Charlotte, NC 28207-1468
Phone (704) 749-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040807000278 NC Practitioner - Anesthesiology 0446222731 Reassigns benefits to 1 organization
I20180418001038 SC Practitioner - Anesthesiology 0446222731 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Anesthesiology Associates PAGroup PAC ID 3971566761, 218 clinicians

Practice addresses (Care Compare)

10030 Gilead Rd
Huntersville, NC 28078-7545
Phone (704) 316-4000

1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone (704) 384-6500

1800 E 4TH St
Charlotte, NC 28204-3210
Phone (704) 384-1300

1901 Randolph Rd
Charlotte, NC 28207-1101
Phone (704) 316-2000

1918 Randolph Rd
Suite 740
Charlotte, NC 28207-1167
Phone (704) 316-0810

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200400261NCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Anesthesiology Associates, P.a. Anesthesiology CurrentSince Aug 15, 2005 Accepting new patients
Ambulatory Anesthesia of Pinehurst, PA Anesthesiology Past Accepting new patients

Locations

200 Providence Rd
Ste 101
Charlotte, NC 28207

131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101

3735 Glenlake Dr
Ste 250
Charlotte, NC 28208
Phone (704) 749-5801

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

2536 Lengers Way
Indian Land, SC 29707
Phone (803) 313-3294

Organizations & group practices 3

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 6

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": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1427043470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PROVIDENCE RD",
            "address_2": "SUITE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071468",
            "telephone_number": "704-749-5800",
            "fax_number": "704-749-5819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PROVIDENCE RD",
            "address_2": "SUITE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071468",
            "telephone_number": "704-749-5800",
            "fax_number": "704-749-5819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOOK",
        "first_name": "PAUL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "200400261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.