Individual provider Active NPI

Shane Edward Downey, DMD

  • General Practice Dentistry
  • Chatsworth, GA
National Provider Identifier
1477573145
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
012190 Issued in GA
Practice address
221 N 4TH Ave
Chatsworth, GA 30705-2420
Phone
(706) 695-8318
Fax
(706) 695-7857
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 012190 GA Primary

Addresses

Primary practice location

221 N 4TH Ave
Chatsworth, GA 30705-2420

Mailing address

PO Box 1096
Chatsworth, GA 30705-1096
Phone (706) 695-8318

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

State licenses

LicenseStateTypeSpecialty
012190GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Chatsworth Family Dentistry, PC Past Accepting new patients

Organizations & group practices 1

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477573145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1096",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307051096",
            "telephone_number": "706-695-8318",
            "fax_number": "706-695-7857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 N 4TH AVE",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307052420",
            "telephone_number": "706-695-8318",
            "fax_number": "706-695-7857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOWNEY",
        "first_name": "SHANE",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "012190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatsworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.