Anthony Shane Black, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1638 Issued in AL

Practice address

1491 Hartford Hwy
Dothan, AL 36301-3349

Phone

(334) 673-1488

Fax

(334) 673-8798

NPI assigned

Mar 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Elevate Medical, LLC

  • Integrative Medicine Physician
  • Dothan, AL
  • NPI 1013696814
  NPD (past)

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378684800000",
    "number": "1497724645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6853",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363026853",
            "telephone_number": "334-673-1488",
            "fax_number": "334-673-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1491 HARTFORD HWY",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013349",
            "telephone_number": "334-673-1488",
            "fax_number": "334-673-8798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "ANTHONY",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2013-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "1638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1497724645",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PALMETTO",
            "identifier": "350045914",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51078506",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassidy Morgan Birge
• Harriet Bissette, PMHNP-BC
• Austin Wyatt Bivins, CRNP
• Misty Bixby, CRNA
• Jennifer Black-Hardwick, MS, LPC
• Jawaunna Talon Blackmon, M.D.
• Keith A. Blackmon, D.D.S.
• Ryan Douglas Blackwell
• Kelley E Blake, CRNP
• Blakes Enrichment Services LLC

• Chiropractor in Dothan, AL
• Providers in Dothan, AL by specialty
• Chiropractor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; 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.