Active NPI
James David Shadoan, MD
- Family Medicine Physician
- Cadillac, MI
National Provider Identifier
1821495532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4301023343
- Practice address
- 133 N. Shore Dr E.
Cadillac, MI 49601 - Phone
- (231) 779-8113
- NPI assigned
- Nov 24, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301023343 | MI | Primary |
Addresses
Primary practice location
133 N. Shore Dr E.
Cadillac, MI 49601
Mailing address
133 N. Shore Drive E
Cadillac, MI 49601
Phone (231) 779-8113
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301023343 | MI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416787200000",
"number": "1821495532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "133 N. SHORE DRIVE E",
"city": "CADILLAC",
"state": "MI",
"postal_code": "49601",
"telephone_number": "231-779-8113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 N. SHORE DR E.",
"city": "CADILLAC",
"state": "MI",
"postal_code": "49601",
"telephone_number": "231-779-8113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHADOAN",
"first_name": "JAMES",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-11-24",
"last_updated": "2014-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301023343",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cadillac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.