Sonja Maia Shanley, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9701146 Issued in NC

Practice address

1410 Commonwealth Dr
Ste 100
Wilmington, NC 28403-0376

Phone

(910) 679-4784

Fax

(910) 777-5453

NPI assigned

Jun 26, 2006

Last updated

Jul 19, 2013By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2022 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wilmington Proactive Medicine, PA

  • Primary Care Clinic/Center
  • Wilmington, NC
  • NPI 1124467584
  NPD

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374192000000",
    "number": "1699702894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 COMMONWEALTH DR",
            "address_2": "STE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284030376",
            "telephone_number": "910-679-4784",
            "fax_number": "910-777-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 COMMONWEALTH DR",
            "address_2": "STE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284030376",
            "telephone_number": "910-679-4784",
            "fax_number": "910-777-5453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANLEY",
        "first_name": "SONJA",
        "middle_name": "MAIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2013-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9701146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891056X",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charlotte Shah, LCMHC, LCAS, CSI
• Fred Thomas Paul Shah, LCMHC, LCASA
• Jehan Rahim Shah, MD
• Robert M Shakar, MD
• Kendall Nicole Shalley, DPT
• Trevor Shannon, PHD
• Daniel Irving Shapiro, PA-C
• Falyne Rynee Shapiro, MD
• Linda R Sharenow, RD ,CDE
• Sharp Counseling, PLLC

• Family Medicine Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.