SHAYNE R SQUIRES (NPI# 1043257090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043257090 |
| Entity Type | Individual |
| Full Name | SHAYNE R SQUIRES |
| Credential | M.D. |
| Practice Address |
2151 W Spring St Ste B110 Monroe GA 30655-3209 |
| Mailing Address |
2727 Paces Ferry Rd Se Ste 1-1100 Atlanta GA 30339-6151 |
| Practice Telephone | 7702671895 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2020-01-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
77557 | GA | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
62453 | WI | Allopathic & Osteopathic Physicians |
| N | 207U00000X | Nuclear Medicine | 34402 | IA | Allopathic & Osteopathic Physicians |
| N | 207U00000X | Nuclear Medicine | 223248 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 1043257090 | 05 |
| Street Address |
2151 W SPRING ST STE B110 |
| City | MONROE |
| State | GA |
| Zip Code | 30655-3209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558968149 | Coresa Hawanis Thomas | Counselor | Advantage Behavioral Health, 384 State Hwy 11 Sw, Walton, GA 30655 | 2020-10-06 |
| 1821629049 | Daniel A Hodges | Dentist | 1190 West Spring St, Suite A, Monroe, GA 30655 | 2020-01-27 |
| 1669019071 | Daniel Bradley Hodges | Dentist | 1190 W. Spring St, Monroe, GA 30655 | 2019-12-04 |
| 1861962730 | Danny Shoemake | Counselor | 2080 Highway 78 Nw, Monroe, GA 30655 | 2018-12-04 |
| 1205329687 | Advantage Behavioral Health Systems | Clinic/Center | 638 Michael Cir., Monroe, GA 30655 | 2018-06-11 |
| 1144722455 | Catherine Williams | Behavioral Analyst | 109 Blaine Street, Monroe, GA 30655 | 2018-03-02 |
| 1588186811 | Francette Dubuche Bernard | Nurse Practitioner | 398 Highway 11, Sw, Monroe, GA 30655 | 2017-07-07 |
| 1437699006 | Amanda Kaye Green | Nurse Practitioner | 517 Great Oaks Drive Suite 103, Monroe, GA 30655 | 2017-03-02 |
| 1639528524 | Matthew Bradford Allgood | Physical Therapist | 2120 W Spring St Ste 1500, Monroe, GA 30655 | 2016-06-10 |
| 1477939221 | Healthy Home Transitions | Social Worker | 506 S Broad Street, Monroe, GA 30655 | 2015-08-04 |
| Find all providers in zip 30655 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902443310 | Affinity Health Gorup, LLC | Internal Medicine | 2516 Broadmoor Blvd Ste 2, Monroe, LA 71201-2988 | 2019-12-04 |
| 1235372426 | D. Scott Burkett, M.d. (a Medial Corporation) | Internal Medicine | 513 Walnut St, Monroe, LA 71201-6229 | 2009-04-17 |
| 1023291226 | Affinity Health Group, LLC | Internal Medicine | 112 Saint. John Street, Monroe, LA 71201 | 2007-12-11 |
| 1033281811 | Advanced Heart Care | Internal Medicine | 1414 Stewart Rd, Monroe, MI 48162-9228 | 2006-11-15 |
| 1982799532 | Northeast Louisiana Cardiovascular | Internal Medicine | 2503 Broadmoor Blvd, Monroe, LA 71201-2987 | 2006-10-03 |
| 1528170255 | Kurt D Olinde | Internal Medicine | 3370 Deborah Dr, Monroe, LA 71201-2151 | 2006-08-31 |
| 1841237286 | Rezaul Islam | Internal Medicine | 3100 Forsythe Ave, Monroe, LA 71201-3014 | 2006-06-02 |
| 1841274768 | Godfrey Achilihu | Internal Medicine | 614 N 2nd St, Monroe, LA 71201-6236 | 2005-12-05 |
| 1205820255 | Emile Anthony Barrow Jr. | Internal Medicine | 1100 N 18th St Ste 100, Monroe, LA 71201-5712 | 2005-09-06 |
| 1619517281 | Affinity Health Gorup, LLC | Internal Medicine | 2516 Broadmoor Blvd Ste 2c-2, Monroe, LA 71201-2988 | 2020-01-13 |
| Find all providers in MONROE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.