Organization Active NPI

Pro-Med, P.C.

  • Family Medicine Physician
  • Greenville, AL
National Provider Identifier
1811957467
Registry record updated Oct 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19482 Issued in AL
Legal business name
PRO-MED, P.C.
Practice address
302 Paul Stabler Drive
Greenville, AL 36037-3871
Phone
(334) 382-0530
Fax
(334) 382-0498
NPI assigned
Mar 27, 2006
Last updated
Oct 4, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2010

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

Authorized official

Name
Dr. Chandra Shekar, M.D.NPI 1881889624
Title
President
Phone
(334) 382-0530

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 19482 AL Primary

Addresses

Primary practice location

302 Paul Stabler Drive
Greenville, AL 36037-3871

Mailing address

302 Paul Stabler Dr
Greenville, AL 36037-3128
Phone (334) 382-0530

Other identifiers 1

IdentifierTypeStateIssuer
000030326MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080926000086 AL Part B Supplier - Clinic/Group Practice 0941377386 Receives reassigned benefits from 1 practitioner
Practice locations: Greenville, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0909012Pro-Med PC302 Paul Stabler Drive, Greenville, AL 36037Certificate of waiverJun 10, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286150400000",
    "number": "1811957467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 PAUL STABLER DR",
            "city": "GREENVILLE",
            "state": "AL",
            "postal_code": "360373128",
            "telephone_number": "334-382-0530",
            "fax_number": "334-382-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 PAUL STABLER DRIVE",
            "city": "GREENVILLE",
            "state": "AL",
            "postal_code": "360373871",
            "telephone_number": "334-382-0530",
            "fax_number": "334-382-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-MED, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-27",
        "last_updated": "2010-10-04",
        "status": "A",
        "authorized_official_last_name": "SHEKAR",
        "authorized_official_first_name": "CHANDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-382-0530",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "19482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000030326",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.