Active NPI
Danny Hicham Shaban, DO
- Student in an Organized Health Care Education/Training Program
- Willington, NC
National Provider Identifier
1982192217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1705 Gardner Rd
Willington, NC 28405 - Phone
- (910) 343-5300
- Fax
- (844) 531-7818
- NPI assigned
- Apr 23, 2018
- Last updated
- Aug 16, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 2022-01784 | NC | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1705 Gardner Rd
Willington, NC 28405
Mailing address
901 Nutt St, Apt 509
Wilmington, NC 28401
Phone (804) 869-6664
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180716001815 | VA | Order and Referring Only - Psychiatry | 4587911037 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022-01784 | NC | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660608000000",
"number": "1982192217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 NUTT ST, APT 509",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "28401",
"telephone_number": "804-869-6664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 GARDNER RD",
"city": "WILLINGTON",
"state": "NC",
"postal_code": "28405",
"telephone_number": "910-343-5300",
"fax_number": "844-531-7818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHABAN",
"first_name": "DANNY",
"middle_name": "HICHAM",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-23",
"last_updated": "2022-08-16",
"certification_date": "2022-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NC",
"license": "2022-01784",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.