Shades Valley Dermatology, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

23903 Issued in AL

Legal business name

SHADES VALLEY DERMATOLOGY, LLC

Practice address

1600 5TH Ave S
Jasper, AL 35501-4658

Phone

(205) 578-1799

Fax

(205) 512-1111

NPI assigned

Jun 13, 2016

Organization subpart

No

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

Authorized official

Name

Katherine FlanaganNPI 1104092675

Title

MD

Phone

(205) 578-1799

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katherine Flanagan, MD

  • Dermatology Physician
  • Jasper, AL
  • NPI 1104092675
  Medicare reassignment Care Compare group NPD Authorized official
• Chelsi Ganus Davis, PA-C

  • Surgical Physician Assistant
  • Jasper, AL
  • NPI 1225692098
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1831548668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 5TH AVE S",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355014658",
            "telephone_number": "205-578-1799",
            "fax_number": "205-512-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 5TH AVE S",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355014658",
            "telephone_number": "205-578-1799",
            "fax_number": "205-512-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1360 Montgomery Hwy Ste 114",
            "address_purpose": "LOCATION",
            "city": "Vestavia Hills",
            "state": "AL",
            "postal_code": "352162750",
            "country_code": "US",
            "telephone_number": "205-578-1799",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "813 Shades Creek Pkwy Ste 205",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352094512",
            "country_code": "US",
            "telephone_number": "205-578-1799",
            "fax_number": "205-578-3158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHADES VALLEY DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-13",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A",
        "authorized_official_last_name": "FLANAGAN",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "205-578-1799"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "AL",
            "license": "23903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Seals, CRNP
• Peter Strom Selikoff, M.D.
• Richard Anthony Sellers, ALC06191
• Emily Ivey Sentell, CCC-SLP
• Richard Daryl Shackleford, LMT
• Shadescrest Health Care Center
• Cassidy Shadinger, PHARMD
• Mohammed Sharif
• Jennifer Shay, LMSW
• Teresa Hindman Sherer, PHARM. D.

• Dermatology Physician in Jasper, AL
• Providers in Jasper, AL by specialty
• Dermatology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.