NPIMap

Individual provider Active NPI

Sean Brian Bohannon, M.D.

  • Family Medicine Physician
  • Selma, AL
National Provider Identifier
1881851491
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.30834 Issued in AL
Practice address
203 Vaughan Memorial Dr
Selma, AL 36701-6950
Phone
(334) 375-8007
Fax
(334) 526-1849
NPI assigned
May 21, 2008
Last updated
Sep 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD.30834 AL
Family Medicine Physician 207Q00000X MD.30834 AL Primary

Addresses

Primary practice location

203 Vaughan Memorial Dr
Selma, AL 36701-6950

Mailing address

PO Box 570
Selma, AL 36702-0570
Phone (334) 375-8007

Other identifiers 1

IdentifierTypeStateIssuer
129899MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20110712000058 AL Practitioner - Family PracticePractitioner - Emergency Medicine 2961689518 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Contracting Services LLCGroup PAC ID 3971417825, 404 clinicians
Selma Family Care PCGroup PAC ID 1951654763, 3 clinicians

Practice addresses (Care Compare)

1015 Medical Ctr Pkwy
Selma, AL 36701-6748
Phone (334) 418-5999

203 Vaughan Memorial Dr
Selma, AL 36701-6950
Phone (334) 375-8007

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.30834ALMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Selma Family Care PC Family Medicine CurrentSince Jul 1, 2018 Accepting new patients
Vaughan Physician Practices LLC Past Accepting new patients
Vaughan Physician Practices LLC Past Accepting new patients
Floyd Emergency Physicians, LLC Emergency Medicine Past Accepting new patients

Locations

203 Vaughan Memorial Dr
Selma, AL 36701
Phone (334) 375-8007

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17793/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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

Hospital & facility affiliations 4

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": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1881851491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 570",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367020570",
            "telephone_number": "334-375-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 VAUGHAN MEMORIAL DR",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367016950",
            "telephone_number": "334-375-8007",
            "fax_number": "334-526-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHANNON",
        "first_name": "SEAN",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-21",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "MD.30834",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD.30834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129899",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Selma, AL

Sources for this page

Verify at the official NPI Registry.