NPIMap

Organization Active NPI

Jeffrey M Shadle MD PA

Doing business as Premier Healthcare of North Texas

  • Family Medicine Physician
  • Plano, TX
National Provider Identifier
1942368980
Registry record updated Nov 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JEFFREY M SHADLE MD PA
Doing business as
Premier Healthcare of North Texas
Practice address
4682 McDermott Rd # 100
Plano, TX 75024-7772
Phone
(972) 596-6400
Fax
(972) 867-4766
NPI assigned
Dec 4, 2006
Last updated
Nov 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2013

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

Authorized official

Name
Jeffrey M Shadle, MDNPI 1386632735
Title
President/Owner
Phone
(972) 596-6400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

4682 McDermott Rd # 100
Plano, TX 75024-7772

Mailing address

4682 McDermott Rd # 100
Plano, TX 75024-7772
Phone (972) 596-6400

Other names 1

  • Premier Healthcare of North Texas Doing business as

National Provider Directory

National Provider Directory

Locations

1708 Coit Rd
Ste 220A
Plano, TX 75075
Phone (972) 596-6400

4682 McDermott Rd
Ste 10
Plano, TX 75024
Phone (972) 596-6400

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384732800000",
    "number": "1942368980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4682 MCDERMOTT RD # 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750247772",
            "telephone_number": "972-596-6400",
            "fax_number": "972-867-4766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4682 MCDERMOTT RD # 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750247772",
            "telephone_number": "972-596-6400",
            "fax_number": "972-867-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY M SHADLE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2013-11-18",
        "status": "A",
        "authorized_official_last_name": "SHADLE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "972-596-6400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Healthcare of North Texas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; 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.