Five Star Diagnostics LLC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

Legal business name

FIVE STAR DIAGNOSTICS LLC

Practice address

1028 Grande View Pass
Maylene, AL 35114-4004

Phone

(205) 478-1200

NPI assigned

Apr 6, 2017

Last updated

Feb 27, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cedric Shannon

Title

Owner/Ceo

Phone

(205) 478-1200

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, AL, GA, NC4 enrollments

Enrollment records 4

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Barry G Collins, MD

  • Internal Medicine Physician
  • Pell City, AL
  • NPI 1851376610
  Medicare reassignment NPD
• Jason Andrew Berner, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Jasper, GA
  • NPI 1144201781
  Medicare reassignment NPD
• Daniela M. Whiteside, MD

  • Ophthalmology Physician
  • Cornelius, NC
  • NPI 1134352867
  Medicare reassignment NPD
• Erica Madden, O.D.

  • Optometrist
  • Montgomery, AL
  • NPI 1346477106

  GA

  Medicare reassignment
• Jocelyn A Myers, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Myrtle Beach, SC
  • NPI 1063498335
  Medicare reassignment
• Sheri Sullins Buckley, DNP, ANP-BC, FNP-C

  • Family Nurse Practitioner
  • Canton, GA
  • NPI 1073807855
  NPD (past)
• Lauralie Gibson Korey, P.A.

  • Medical Physician Assistant
  • Atlanta, GA
  • NPI 1295885911
  NPD (past)
• Kirby Brown Reinecke, PA-C

  • Medical Physician Assistant
  • Canton, GA
  • NPI 1093047474
  NPD (past)

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582761600000",
    "number": "1558894576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 GRANDE VIEW PASS",
            "city": "MAYLENE",
            "state": "AL",
            "postal_code": "351144004",
            "telephone_number": "205-478-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 GRANDE VIEW PASS",
            "city": "MAYLENE",
            "state": "AL",
            "postal_code": "351144004",
            "telephone_number": "205-478-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-06",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "CEDRIC",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "205-478-1200"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bloom Pediatric Therapy, LLC
• Ashley Dixon
• Fertile Ground, LLC
• Jessica Emmons Garzarek, MA, CCC-SLP
• Ellan Harris, LAT, ATC
• Patricia Pollard Howard, D.C
• Jean Care for Hospice LLC
• Anne Abernathy Maddox, OT

• Endocrinology, Diabetes & Metabolism Physician in Maylene, AL
• Providers in Maylene, AL by specialty
• Endocrinology, Diabetes & Metabolism Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.