Mark A Shina, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

E-11636 Issued in AR

Practice address

415 Hospital Dr Ste 3
Camden, AR 71701

Phone

(870) 837-2888

NPI assigned

Jun 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533254400000",
    "number": "1720020647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 HOSPITAL DR STE 3",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "717014651",
            "telephone_number": "870-837-2888",
            "fax_number": "870-837-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 HOSPITAL DR STE 3",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "71701",
            "telephone_number": "870-837-2888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "412 N SAWYER RD",
            "address_purpose": "LOCATION",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467552572",
            "country_code": "US",
            "telephone_number": "260-347-4900",
            "fax_number": "260-347-4966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHINA",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2018-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "23428",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "E-11636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100020000A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64234289",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Salon One Twenty Four L.L.C.
• Gloria D Sams
• Jan Scantling, APRN
• Alyssa L Scott-Nutt, O.D.
• Natalie Sherman, BA SLP-A
• Bal N. Shrestha, M.D.
• Kelsey Lauren Simpson
• Hannah Singleton, M.S.
• Hayden Smith, DDS
• Jerakaycia Smith, M.D.

• Surgery Physician in Camden, AR
• Providers in Camden, AR by specialty
• Surgery Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; 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.