Individual provider Active NPI

Mitchell Carey Shirah, M.D.

  • Family Medicine Physician
  • Roanoke, AL
National Provider Identifier
1902889371
Registry record updated Mar 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9705 Issued in AL
Practice address
59664 Highway 22
Roanoke, AL 36274-4438
Phone
(334) 863-8952
Fax
(334) 863-2361
NPI assigned
Nov 21, 2005
Last updated
Mar 29, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2013

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 9705 AL Primary

Addresses

Primary practice location

59664 Highway 22
Roanoke, AL 36274-4438

Mailing address

59664 Highway 22
Roanoke, AL 36274-4438
Phone (334) 863-8952

Other identifiers 4

IdentifierTypeStateIssuer
P00181558OtherRAILROAD MEDICARE
000010937OtherMEDICARE
000010937MedicaidAL
51525162OtherALBCBS OF AL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040616000164 AL Practitioner - Family PracticePractitioner - Emergency Medicine 4981688033 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Alabama College of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

59664 Hwy 22
Roanoke, AL 36274-4438
Phone (334) 863-8951

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mitchell C. Shirah M.D. P.C. Family Medicine CurrentSince Jan 1, 2005 Accepting new patients
App of Alabama Ed PLLC CurrentSince Apr 1, 2012 Accepting new patients
Roanoke Healthcare Center LLC Past Accepting new patients
Randolph Management Company, Inc. Past Accepting new patients

Locations

400 E 10th St
Anniston, AL 36207
Phone (256) 235-5121

83825 Highway 9
Ashland, AL 36251
Phone (256) 354-1195

4370 W Main St
Dothan, AL 36305
Phone (256) 332-1611

1701 Pelham Rd S
Jacksonville, AL 36265
Phone (256) 435-4970

4441 Highway 431
Ste 1
Roanoke, AL 36274
Phone (334) 863-8281

59664 Highway 22
Roanoke, AL 36274
Phone (334) 863-8951

Networks

  • bcbs alabama network 01H0
  • bcbs alabama network 01C0
  • bcbs alabama network 01E0
  • bcbs alabama network 01A0
  • bcbs alabama network 01B0
  • bcbs alabama network 01G0

Interoperability endpoints

  • Direct secure messaging: mitchell.shirah.1@15682.direct.athenahealth.com

Organizations & group practices 4

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 6

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364515200000",
    "number": "1902889371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59664 HIGHWAY 22",
            "city": "ROANOKE",
            "state": "AL",
            "postal_code": "362744438",
            "telephone_number": "334-863-8952",
            "fax_number": "334-863-2361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59664 HIGHWAY 22",
            "city": "ROANOKE",
            "state": "AL",
            "postal_code": "362744438",
            "telephone_number": "334-863-8952",
            "fax_number": "334-863-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRAH",
        "first_name": "MITCHELL",
        "middle_name": "CAREY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2013-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "9705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00181558",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "000010937",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000010937",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "51525162",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, AL

Sources for this page

Verify at the official NPI Registry.