NPIMap

Individual provider Active NPI

Mary Denise Shearin, MD

  • Gastroenterology Physician
  • High Point, NC
National Provider Identifier
1780604363
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
34226 Issued in NC
Practice address
624 Quaker LN
Suite 105C
High Point, NC 27262-3832
Phone
(336) 802-2105
Fax
(336) 802-2106
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34226 NC
Gastroenterology Physician 207RG0100X 34226 NC Primary

Addresses

Primary practice location

624 Quaker LN
Suite 105C
High Point, NC 27262-3832

Mailing address

1701 Westchester Drive
Suite 850
High Point, NC 27262-7254
Phone (336) 802-2400

Other identifiers 2

IdentifierTypeStateIssuer
8975928MedicaidNC
100008459OtherNCRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100108000684 NC Practitioner - GastroenterologyPractitioner - Internal Medicine 0345381653 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest Health Network LLCGroup PAC ID 4183538895, 276 clinicians

Practice addresses (Care Compare)

1814 Westchester Dr
High Point, NC 27262-7369

601 N Elm St
High Point, NC 27262-4331
Phone (336) 716-2734

770 Highland Oaks Dr
Winston Salem, NC 27103-7105
Phone (336) 765-5250

905 Phillips Ave
High Point, NC 27262-7075
Phone (336) 802-2040

Medical Ctr Blvd
Winston Salem, NC 27157-0001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy101
Upper gastrointestinal (GI) endoscopy for acid reflux88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34226NCMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Health Care, PA CurrentSince Jan 1, 1998 Accepting new patients
Wake Forest University Health Sciences Gastroenterology CurrentSince Jan 1, 2021 Accepting new patients
Wake Forest Health Network LLC Current Accepting new patients
Wake Forest Health Network, LLC CurrentSince Jan 1, 1998 Accepting new patients
Wake Forest Health Network LLC Internal Medicine Past Accepting new patients
Cornerstone Health Care PA Past Accepting new patients
Wake Forest Health Network LLC Past Accepting new patients
Wake Forest Health Network, LLC Past Accepting new patients

Locations

1814 Westchester Dr
Ste 103
High Point, NC 27262
Phone (336) 716-6099

624 Quaker Ln
Ste 105C
High Point, NC 27262
Phone (336) 802-2105

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

601 N Elm St
High Point, NC 27262
Phone (336) 878-6419

1814 Westchester Dr
Ste 101
High Point, NC 27262
Phone (336) 802-2105

1701 Westchester Dr
Ste 850
High Point, NC 27262
Phone (336) 802-2400

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Interoperability endpoints

  • Direct secure messaging: mshearin2754670@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1780604363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WESTCHESTER DRIVE",
            "address_2": "SUITE 850",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627254",
            "telephone_number": "336-802-2400",
            "fax_number": "336-802-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 QUAKER LN",
            "address_2": "SUITE 105C",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272623832",
            "telephone_number": "336-802-2105",
            "fax_number": "336-802-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEARIN",
        "first_name": "MARY",
        "middle_name": "DENISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "34226",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "34226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8975928",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100008459",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.