Active NPI
Donald T Shafer, MD
- Anesthesiology Physician
- Greensboro, NC
National Provider Identifier
1891746822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 20342
- Practice address
- 3625 N Elm St
Suite 110a
Greensboro, NC 27455-2604 - Phone
- (336) 282-4840
- Fax
- (336) 282-4660
- NPI assigned
- May 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 20342 | NC | Primary |
Addresses
Primary practice location
3625 N Elm St
Suite 110a
Greensboro, NC 27455-2604
Mailing address
3625 N Elm St
Suite 110a
Greensboro, NC 27455-2604
Phone (336) 282-4840
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5714591 | Medicaid | VA | |
| 75290 | Other | NC | BCBS |
| 8975290 | Medicaid | NC |
Other names 1
- Donald T. Shafer
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20342 | NC | MD | Sports Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greensboro Anesthesia Physicians,PC | Anesthesiology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Greensboro, NC
- NPI 1427008440
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268611200000",
"number": "1891746822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3625 N ELM ST",
"address_2": "SUITE 110A",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274552604",
"telephone_number": "336-282-4840",
"fax_number": "336-282-4660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3625 N ELM ST",
"address_2": "SUITE 110A",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274552604",
"telephone_number": "336-282-4840",
"fax_number": "336-282-4660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFER",
"first_name": "DONALD",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-15",
"last_updated": "2010-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NC",
"license": "20342",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5714591",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "75290",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8975290",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DONALD",
"last_name": "SHAFER",
"middle_name": "T.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.