Jack F Shamblin III, MD

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

17829 Issued in WV

Practice address

94 Old Mill Rd
Martinsburg, WV 25401-9284

Phone

(304) 264-8933

Fax

(304) 264-8846

NPI assigned

Mar 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WV

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

Specialty

Anesthesiology

Education

West Virginia University School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

City Hospital IncGroup PAC ID 3375444524, 155 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Berkeley Medical Center Hospital, Martinsburg, WV, CCN 510008
• Jefferson Medical Center Hospital, Ranson, WV, CCN 511319

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• City Hospital Inc

  • Anesthesiology Physician
  • Martinsburg, WV
  • NPI 1942503164
  Medicare reassignment Care Compare group NPD
• City Hospital, Inc.

  • Internal Medicine Physician
  • Ranson, WV
  • NPI 1336657493
  NPD
• Wvuh-East Services, Inc

  • Anesthesiology Physician
  • Martinsburg, WV
  • NPI 1659563104
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• City Hospital, Inc

  • General Acute Care Hospital
  • Martinsburg, WV
  • NPI 1457389249
  Care Compare affiliation
• Jefferson Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Ranson, WV
  • NPI 1104242569
  Care Compare affiliation
• Jefferson Memorial Hospital

  • Internal Medicine Physician
  • Ranson, WV
  • NPI 1316364953

  Hospital

  Care Compare affiliation
• Jefferson Memorial Hospital

  • Critical Access Hospital
  • Ranson, WV
  • NPI 1891722377
  Care Compare affiliation
• Jefferson Memorial Hospital

  • Anesthesiology Physician
  • Ranson, WV
  • NPI 1982704961

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1831159615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 OLD MILL RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254019284",
            "telephone_number": "304-264-8933",
            "fax_number": "304-264-8846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 OLD MILL RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254019284",
            "telephone_number": "304-264-8933",
            "fax_number": "304-264-8846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMBLIN",
        "first_name": "JACK",
        "middle_name": "F",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "WV",
            "license": "17829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0060852000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050065778",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Ann Shaffer
• Sohrab Shahab, M.D.
• Geetha Shakesprere, M.D.
• Julie Beth Shallis, M.S., CCC/A
• Isabelle Shamblin, RDN
• Ashley Brooke Shamburg, PHARM.D.
• Paige Shane
• Amanda Christian Shaner, DNP, FNP-BC
• Alyssa Kay Shank, L.P.C.
• Amanda K Shank, LGSW

• Pain Medicine (Anesthesiology) Physician in Martinsburg, WV
• Providers in Martinsburg, WV by specialty
• Pain Medicine (Anesthesiology) Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.