NPIMap

Individual provider Active NPI

Anthony W Shallin, M.D.

  • Internal Medicine Physician
  • Georgetown, TX
National Provider Identifier
1891734968
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
J2323 Issued in TX
Practice address
3613 Williams Dr
Ste 404
Georgetown, TX 78628-1377
Phone
(512) 930-4275
Fax
(512) 930-4093
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Hospital & facility affiliations 9

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

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Baylor College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3613 Williams Dr
Suite 404
Georgetown, TX 78628-1370
Phone 512930427526

Hospital & facility affiliations

  • Bellcoa Home Health Service Inc Home health agency, Austin, TX, CCN 457871
  • St. David'S Healthcare at Home Home health agency, Austin, TX, CCN 679682
  • Enhabit Home Health Home health agency, Georgetown, TX, CCN 679647
  • Advanced Home Health Services Home health agency, Seguin, TX, CCN 677247
  • Ascension at Home Home health agency, Burnet, TX, CCN 677154
  • St David'S Medical Center Hospital, Austin, TX, CCN 450431
  • Adventhealth Central Texas Hospital, Killeen, TX, CCN 450152
  • Round Rock Medical Center Hospital, Round Rock, TX, CCN 450718
  • Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Lakeway, TX, CCN 673058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050324000875 TX Practitioner - Internal Medicine 5294780367 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kumar Sathianathan, Mdpa Internal Medicine Current Accepting new patients
Tony Shallin, Mdpa Internal Medicine CurrentSince Aug 1, 1999 Accepting new patients

Locations

3613 Williams Dr
Ste 404
Georgetown, TX 78628
Phone (512) 930-4275

902 N Austin Ave
B
Georgetown, TX 78626
Phone (512) 930-4275

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X J2323 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

3613 Williams Dr
Ste 404
Georgetown, TX 78628-1377

Mailing address

3613 Williams Dr
Ste 404
Georgetown, TX 78628-1377
Phone (512) 930-4275

Other names 1

NPPES NPI Registry
  • Dr. Tony Shallin Professional name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 9, 2007.

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1891734968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3613 WILLIAMS DR",
            "address_2": "STE 404",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786281377",
            "telephone_number": "512-930-4275",
            "fax_number": "512-930-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3613 WILLIAMS DR",
            "address_2": "STE 404",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786281377",
            "telephone_number": "512-930-4275",
            "fax_number": "512-930-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALLIN",
        "first_name": "ANTHONY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "J2323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TONY",
            "last_name": "SHALLIN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Georgetown, TX

Sources for this page

Verify at the official NPI Registry.