Individual provider Active NPI

Shawn Seal

  • Family Nurse Practitioner
  • Madison, AL
National Provider Identifier
1609309343
Registry record updated Apr 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-121779 Issued in AL
Practice address
133 Heatherwood Dr
Madison, AL 35758-8259
Phone
(256) 348-5147
NPI assigned
Apr 10, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-121779 AL Primary

Addresses

Primary practice location

133 Heatherwood Dr
Madison, AL 35758-8259

Mailing address

133 Heatherwood Dr
Madison, AL 35758-8259
Phone (256) 348-5147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, TN, GA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20170818002888 AL Practitioner - Nurse Practitioner 0446576748 Reassigns benefits to 1 organization
I20210421000748 TN Practitioner - Nurse Practitioner 0446576748 Reassigns benefits to 2 organizations
I20210429001042 GA Practitioner - Nurse Practitioner 0446576748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Remedy Behavioral Health LLCGroup PAC ID 3375958853, 46 clinicians

Practice addresses (Care Compare)

1265 E College St
Pulaski, TN 36478-4541
Phone (931) 363-7531

1609 Mockingbird CT
Suite B
Florence, AL 35630-7511
Phone (256) 320-7778

4804 Roswell Rd
Atlanta, GA 30342-2606
Phone (256) 320-7781

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Master of Science, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Behavioral Health, LLC Current Accepting new patients
Quad Cities Pediatrics, LLC Past Accepting new patients

Locations

1001 S Jackson Hwy
Sheffield, AL 35660
Phone (256) 320-7778

Organizations & group practices 4

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": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491782400000",
    "number": "1609309343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 HEATHERWOOD DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588259",
            "telephone_number": "256-348-5147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 HEATHERWOOD DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588259",
            "telephone_number": "256-348-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEAL",
        "first_name": "SHAWN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-10",
        "last_updated": "2017-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-121779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.