Shequori K. Clyde, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6767 Issued in AL

Practice address

524 Red Lane Rd
Birmingham, AL 35215-8245

Phone

(205) 836-4044

NPI assigned

Jun 7, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cahaba Medical Care Foundation

  • Federally Qualified Health Center (FQHC)
  • Centreville, AL
  • NPI 1316201809
  Medicare reassignment NPD
• Cahaba Medical Care Foundation

  • Federally Qualified Health Center (FQHC)
  • Centreville, AL
  • NPI 1316542624
  NPD

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

{
    "created_epoch": "1591488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591488000000",
    "number": "1447874292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 RED LANE RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352158245",
            "telephone_number": "205-836-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 RED LANE RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352158245",
            "telephone_number": "205-836-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYDE",
        "first_name": "SHEQUORI",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-07",
        "last_updated": "2020-06-07",
        "certification_date": "2020-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "6767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quintela Clopton, A-CRNP
• Katherine A. Clore, O.D.
• Harrison Loyd Cloud
• Savannah D Clouse, CPNP
• Michael Lee Cloyd, M.D.
• Cnak, LLC
• Coach DJ Taylor
• Keara Nashi Coachman
• Gabrielle Navia Coady, PA-C
• Dawson William Coaker

• General Practice Dentistry in Birmingham, AL
• Providers in Birmingham, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2020; 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.