Individual provider Active NPI

April M Shackleford, MD

  • Emergency Medicine Physician
  • VA Beach, VA
National Provider Identifier
1922209592
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101245492 Issued in VA
Practice address
4092 Foxwood Dr.
Ste 101
VA Beach, VA 23462-5225
Phone
(757) 467-4200
Fax
(757) 686-0541
NPI assigned
May 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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 57010586 OH
Emergency Medicine Physician 207P00000X 0101245492 VA Primary

Addresses

Primary practice location

4092 Foxwood Dr.
Ste 101
VA Beach, VA 23462-5225

Mailing address

P.O. Box 7549
Portsmouth, VA 23707-0549
Phone (757) 686-3525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20090617000369 VA Practitioner - Emergency Medicine 0547320103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
West Virginia University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians of TidewaterGroup PAC ID 5092618462, 167 clinicians

Practice addresses (Care Compare)

2800 Godwin Blvd
Suffolk, VA 23434-8038
Phone (757) 686-3508

Hospital & facility affiliations

  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
  • Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044
  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046

Merit-based Incentive Payment System (MIPS)

Final score
97.87 of 100Reported as group
Quality
95.04
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57010586OHMDEmergency Medicine Physician
0101245492VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Tidewater Emergency Medicine CurrentSince Jul 1, 2009 Accepting new patients
Professional Emergency Specialists of Southern Ohio Emergency Medicine Past Accepting new patients
Professional Emergency Specialists of Southern Ohio Emergency Medicine Past Accepting new patients

Locations

2800 Godwin Blvd
Suffolk, VA 23434
Phone (757) 363-6850

4092 Foxwood Dr
Ste 101
Virginia Beach, VA 23462
Phone (757) 467-4200

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.

Hospital & facility affiliations 3

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1922209592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 7549",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237070549",
            "telephone_number": "757-686-3525",
            "fax_number": "757-686-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4092 FOXWOOD DR.",
            "address_2": "STE 101",
            "city": "VA BEACH",
            "state": "VA",
            "postal_code": "234625225",
            "telephone_number": "757-467-4200",
            "fax_number": "757-686-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACKLEFORD",
        "first_name": "APRIL",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "57010586",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101245492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in VA Beach, VA

Sources for this page

Verify at the official NPI Registry.