Shane A Adkison, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME64880 Issued in FL

Practice address

1399 Country Club Rd
Gulf Breeze, FL 32563-3451

Phone

(850) 934-7258

Fax

(850) 934-7276

NPI assigned

Jun 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Santa Rosa Hma Physician Management, LLC

  • Family Medicine Physician
  • Milton, FL
  • NPI 1447365366
  Medicare reassignment NPD
• Medical Professional Agency Inc

  • Adult Medicine Physician
  • Pensacola, FL
  • NPI 1427174762
  NPD (past)
• Sacred Heart Health System, Inc.

  dba Ascension Medical Group Sacred Heart Urgent Care

  • Urgent Care Clinic/Center
  • Pensacola, FL
  • NPI 1770533077
  NPD (past)
• Tri Hospital MRI Center

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Port Huron, MI
  • NPI 1063581353
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323388800000",
    "number": "1659319515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "telephone_number": "850-934-7258",
            "fax_number": "850-934-7276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1399 COUNTRY CLUB RD",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325633451",
            "telephone_number": "850-934-7258",
            "fax_number": "850-934-7276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADKISON",
        "first_name": "SHANE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2011-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME64880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377670100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel J Abshire Jr., R.PH.
• Absolute OBGYN LLC
• Deborah Achiron
• Chelsey Adams, LAT, ATC
• Melissa Adams, B.S.N., H.C.
• Aegis Group Practice LLC
• Iti Agarwal, DDS
• Julia Aicardi
• Elizabeth Akin, RBT
• Hannah Alberson

• Family Medicine Physician in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; 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.