Shivers Medical Services Limited

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SHIVERS MEDICAL SERVICES LIMITED

Practice address

214 Woodside Drive
Salem, OH 44460-7688

Phone

(330) 614-8411

Fax

(330) 244-8521

NPI assigned

Nov 12, 2021

Organization subpart

No

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

Authorized official

Name

Richard Mark Shivers, MDNPI 1639268352

Title

Owner / MD

Phone

(330) 614-8411

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• R. Mark Shivers Sole MBR Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard Mark Shivers, MD

  • Family Medicine Physician
  • Salem, OH
  • NPI 1639268352
  Medicare reassignment NPD Authorized official
• Gabrielle Eisel, APRN

  • Registered Nurse
  • Poland, OH
  • NPI 1255912762
  Medicare reassignment NPD

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637020800000",
    "number": "1679239727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4347 PORTAGE ST NW",
            "address_2": "SUITE 102",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207371",
            "telephone_number": "330-614-8411",
            "fax_number": "330-244-8521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 WOODSIDE DRIVE",
            "city": "SALEM",
            "state": "OH",
            "postal_code": "444607688",
            "telephone_number": "330-614-8411",
            "fax_number": "330-244-8521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIVERS MEDICAL SERVICES LIMITED",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-12",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A",
        "authorized_official_last_name": "SHIVERS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "OWNER / MD",
        "authorized_official_telephone_number": "330-614-8411",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0975995",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "R. Mark Shivers Sole MBR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael J Sevilla, M.D.
• Ambika Sharma
• Constance Sharp
• Hunter Sheehan, DPT
• Jocelyn Florendo Shimek, D.O.
• Morgan Nicole Shivers, DMD
• Paul Kevin Shivers, DDS
• Richard Mark Shivers, MD
• Herbert J Shultz, OD
• Audrey E Sills, SLP

• Family Medicine Physician in Salem, OH
• Providers in Salem, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.