Individual provider Active NPI

Russell L Shoemaker, D.O.

  • Family Medicine Physician
  • Hendersonville, NC
National Provider Identifier
1891702007
Registry record updated Feb 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
200000310 Issued in NC
Practice address
212 Thompson St Ste a
Hendersonville, NC 28792-2949
Phone
(828) 697-3232
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 200000310 NC Primary

Addresses

Primary practice location

212 Thompson St Ste a
Hendersonville, NC 28792-2949

Mailing address

212 Thompson St Ste a
Hendersonville, NC 28792-2949
Phone (828) 697-3232

Other identifiers 1

IdentifierTypeStateIssuer
89126W5MedicaidNC

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
200000310NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sterling Emergency Services of the Southeast, Inc Past Accepting new patients
Henderson County Hospital Corporation Family Medicine PastSince Oct 1, 1999 Accepting new patients
TST Medical, P.a. Family Medicine Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391644800000",
    "number": "1891702007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 THOMPSON ST STE A",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287922949",
            "telephone_number": "828-697-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 THOMPSON ST STE A",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287922949",
            "telephone_number": "828-697-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOEMAKER",
        "first_name": "RUSSELL",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2014-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200000310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89126W5",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.

Verify at the official NPI Registry.