Individual provider Active NPI

Jeffrey A. Schievenin, M.D.

  • Family Medicine Physician
  • Shaw AFB, SC
National Provider Identifier
1679567143
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME63782 Issued in FL
Practice address
431 Meadowlark
Shaw AFB, SC 29152-5019
Phone
(803) 895-2006
NPI assigned
Sep 9, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME63782 FL Primary

Addresses

Primary practice location

431 Meadowlark
Shaw AFB, SC 29152-5019

Mailing address

431 Meadowlark
Shaw AFB, SC 29152-5019
Phone (803) 895-2006

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110124000578 FL Practitioner - Family Practice 9436338456 Practice locations: Eglin AFB, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME63782FLMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: jeffrey.schievenin.1@19478.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679567143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 MEADOWLARK",
            "city": "SHAW AFB",
            "state": "SC",
            "postal_code": "291525019",
            "telephone_number": "803-895-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 MEADOWLARK",
            "city": "SHAW AFB",
            "state": "SC",
            "postal_code": "291525019",
            "telephone_number": "803-895-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHIEVENIN",
        "first_name": "JEFFREY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME63782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaw AFB, SC

Sources for this page

Verify at the official NPI Registry.