Individual provider Active NPI

Martha Garrett-Shaver, MD

  • Family Medicine Physician
  • El Dorado, AR
National Provider Identifier
1740274448
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-3280 Issued in AR
Practice address
620 W Grove St Ste 202
El Dorado, AR 71730-4425
Phone
(870) 875-5577
Fax
(870) 875-5589
NPI assigned
Sep 8, 2005
Last updated
Feb 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-3280 AR Primary
Family Medicine Physician 207Q00000X E3280 AR

Addresses

Primary practice location

620 W Grove St Ste 202
El Dorado, AR 71730-4425

Mailing address

1617 N Washington
Magnolia, AR 71753-2046
Phone (870) 875-5577

Other identifiers 1

IdentifierTypeStateIssuer
149393001MedicaidAR

Other names 1

  • Martha Gene Shaver Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address martha.garrett-shaver.1@2218.direct.athenahealth.com Direct
Direct Messaging Address martha.garrett-shaver.1@29233.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20031110000677 AR Practitioner - Family Practice 8527971159 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

620 W Grove St
Suite 202
El Dorado, AR 71730-4409
Phone (501) 526-5601

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E3280ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences Family Medicine CurrentSince Mar 1, 2024 Accepting new patients
South Arkansas Physician Group LLC Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
South Arkansas Physician Services LLC Family Medicine CurrentSince Oct 11, 2018 Accepting new patients
University of Arkansas for Medical Sciences Family Medicine Current Accepting new patients
University of Arkansas for Medical Sciences Family Medicine Past Accepting new patients

Locations

620 W Grove St
Ste 202
El Dorado, AR 71730
Phone (870) 863-2420

704 W Grove St
Ste 3
El Dorado, AR 71730
Phone (870) 863-6133

1617 N Washington
Magnolia, AR 71753
Phone (870) 234-7676

1601 W 40th Ave
Pine Bluff, AR 71603

Interoperability endpoints

  • Direct secure messaging: martha.garrett-shaver.1@2218.direct.athenahealth.com
  • Direct secure messaging: martha.garrett-shaver.1@29233.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1740274448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 N WASHINGTON",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532046",
            "telephone_number": "870-875-5577",
            "fax_number": "870-875-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W GROVE ST STE 202",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304425",
            "telephone_number": "870-875-5577",
            "fax_number": "870-875-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT-SHAVER",
        "first_name": "MARTHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-08",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-3280",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E3280",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149393001",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "martha.garrett-shaver.1@2218.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "704 W Grove St Ste 3",
            "city": "El Dorado",
            "state": "AR",
            "country_code": "US",
            "postal_code": "717304469",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "martha.garrett-shaver.1@29233.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "620 W Grove St Ste 202",
            "city": "El Dorado",
            "state": "AR",
            "country_code": "US",
            "postal_code": "717304425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "SHAVER",
            "middle_name": "GENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in El Dorado, AR

Sources for this page

Verify at the official NPI Registry.