Active NPI
Jacob Peter Shaffer, MD
- Anesthesiology Physician
- Chapel Hill, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 2022-02891
- Practice address
- 101 Manning Dr
Chapel Hill, NC 27514-4220 - Phone
- (978) 855-1402
- NPI assigned
- Apr 18, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 251168 | NC | |
| Anesthesiology Physician | 207L00000X | 2022-02891 | NC | Primary |
Addresses
Primary practice location
101 Manning Dr
Chapel Hill, NC 27514-4220
Mailing address
2222 Forestlake Dr
Cincinnati, OH 45244-2803
Phone (978) 855-1402
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Wright State University Boonshoft School of Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1305 Glen Meade Rd
Wilmington, NC 28401-7369
Phone (910) 341-3300
2131 S 17TH St
Wilmington, NC 28401-7407
Phone (910) 343-7000
Hospital & facility affiliations
- Novant Health New Hanover Regional Medical Center
- Novant Health Brunswick Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022-02891 | NC | MD | Anesthesiology Physician |
| 251168 | NC | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Anesthesiology of North Carolina, PLLC | Anesthesiology | Current | Accepting new patients |
| Southeast Anesthesiology Consultants, PLLC | Anesthesiology | Current | Accepting new patients |
| Southeast Anesthesiology Consultants, PLLC | Anesthesiology | Current | Accepting new patients |
| American Anesthesiology of North Carolina, PLLC | Anesthesiology | Current | Accepting new patients |
Locations
1168 E Cutlar Crossing
Ste 101
Leland, NC 28451
Phone (910) 332-1550
1333 S Dickinson Dr
Unit 120
Leland, NC 28451
Phone (910) 763-2361
4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034
924 N Howe St
Southport, NC 28461
Phone (910) 457-3800
2520 Independence Blvd
Ste 200
Wilmington, NC 28412
Phone (910) 442-1100
5301 Wrightsville Ave
Wilmington, NC 28403
Phone (910) 452-8100
105 Scotts Hill Medical Dr
Wilmington, NC 28411
Phone (910) 686-2840
2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000
1305 Glen Meade Rd
Wilmington, NC 28401
Phone (910) 815-6100
1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796
Organizations & group practices 5
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
- Wilmington, NC
- NPI 1033412267
-
- Anesthesiology Physician
- Charlotte, NC
- NPI 1538124201
-
- Anesthesiology Physician
- Asheville, NC
- NPI 1457719130
-
- Certified Registered Nurse Anesthetist
- Burlington, NC
- NPI 1053677195
Anesthesiology
-
- Anesthesiology Physician
- Wilmington, NC
- NPI 1932402195
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bolivia, NC
- NPI 1710915756
-
- General Acute Care Hospital
- Wilmington, NC
- NPI 1376139139
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689638400000",
"number": "1942863535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2222 FORESTLAKE DR",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452442803",
"telephone_number": "978-855-1402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 MANNING DR",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "275144220",
"telephone_number": "978-855-1402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFER",
"first_name": "JACOB",
"middle_name": "PETER",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-18",
"last_updated": "2023-07-18",
"certification_date": "2023-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NC",
"license": "251168",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NC",
"license": "2022-02891",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chapel Hill, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.