Active NPI
Shelly Bade, M.D.
- General Practice Physician
- Orlando, FL
National Provider Identifier
1710108980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 99273
- Practice address
- 716 S Goldenrod Rd
Orlando, FL 32822-8108 - Phone
- (407) 658-1719
- NPI assigned
- May 2, 2007
- Last updated
- Dec 1, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 99273 | FL | Primary |
Addresses
Primary practice location
716 S Goldenrod Rd
Orlando, FL 32822-8108
Mailing address
716 S Goldenrod Rd
Orlando, FL 32822-8108
Phone (407) 658-1719
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 99273 | FL | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bucyrus Emergency Physicians Inc | Past | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Mohammed H Bawany MD P a | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba Bucyrus Emergency Physicians/Bucyrus Community
- Emergency Medicine Physician
- Bucyrus, OH
- NPI 1073513164
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259625600000",
"number": "1710108980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "716 S GOLDENROD RD",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328228108",
"telephone_number": "407-658-1719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "716 S GOLDENROD RD",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328228108",
"telephone_number": "407-658-1719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BADE",
"first_name": "SHELLY",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-02",
"last_updated": "2009-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "FL",
"license": "99273",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.