Shaver Medical, PC

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

056647 Issued in GA

Legal business name

SHAVER MEDICAL, PC

Doing business as

DBA: Integrative Sports Medicine of Blue Ridge

Practice address

980 E Main St
Suite #300
Blue Ridge, GA 30513-7139

Phone

(706) 632-5454

Fax

(706) 632-5451

NPI assigned

Apr 12, 2010

Organization subpart

No

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

Authorized official

Name

Stefanie L Shaver, MD

Title

Owner

Phone

(706) 632-5454

Specialties & licenses 2

Addresses

Other names 1

• DBA: Integrative Sports Medicine of Blue Ridge Doing business as

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

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271203200000",
    "number": "1730405069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 E MAIN ST",
            "address_2": "SUITE #300",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305137139",
            "telephone_number": "706-632-5454",
            "fax_number": "706-632-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 E MAIN ST",
            "address_2": "SUITE #300",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305137139",
            "telephone_number": "706-632-5454",
            "fax_number": "706-632-5451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAVER MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-12",
        "last_updated": "2010-04-14",
        "status": "A",
        "authorized_official_last_name": "SHAVER",
        "authorized_official_first_name": "STEFANIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-632-5454",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "056647",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "GA",
            "license": "056647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA: Integrative Sports Medicine of Blue Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Sports Medicine (Family Medicine) Physician in Blue Ridge, GA
• Providers in Blue Ridge, GA by specialty
• Sports Medicine (Family Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.