Active NPI
Michael Shane Garrett, M.D.
- Anesthesiology Physician
- Jbsa Lackland, TX
National Provider Identifier
1992773527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- S3816
- Practice address
- 1100 Wilford Hall Loop BLDG Wilford
Jbsa Lackland, TX 78236-5638 - Phone
- (210) 292-7759
- NPI assigned
- Mar 9, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 01054120A | IN | |
| Anesthesiology Physician | 207L00000X | 48430 | CO | |
| Anesthesiology Physician | 207L00000X | S3816 | TX | Primary |
Addresses
Primary practice location
1100 Wilford Hall Loop BLDG Wilford
Jbsa Lackland, TX 78236-5638
Mailing address
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone (210) 916-9946
Other practice location 1
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone (210) 916-9946
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48430 | CO | MD | Anesthesiology Physician |
| 01054120A | IN | MD | Anesthesiology Physician |
| S3816 | TX | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678320000000",
"number": "1992773527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504",
"telephone_number": "210-916-9946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 WILFORD HALL LOOP BLDG WILFORD",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "782365638",
"telephone_number": "210-292-7759"
}
],
"practiceLocations": [
{
"address_1": "3551 Roger Brooke Dr",
"address_purpose": "LOCATION",
"city": "Fort Sam Houston",
"state": "TX",
"postal_code": "782344504",
"country_code": "US",
"telephone_number": "210-916-9946",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GARRETT",
"first_name": "MICHAEL",
"middle_name": "SHANE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-09",
"last_updated": "2023-03-09",
"certification_date": "2023-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IN",
"license": "01054120A",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CO",
"license": "48430",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TX",
"license": "S3816",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jbsa Lackland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.