DR. JAMES LYMAN SHIVELY (NPI# 1043518095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043518095 |
| Entity Type | Individual |
| Full Name | DR. JAMES LYMAN SHIVELY |
| Credential | M.D. |
| Practice Address |
747 52nd St Oakland CA 94609-1809 |
| Mailing Address |
747-fifty Second Street Children's Hospital Oakland CA 94609-1809 |
| Practice Telephone | 5104283000 |
| Mailing Telephone | 5104283000 |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2013-09-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207XX0801X |
Orthopaedic Surgery Specialization: Orthopaedic Trauma |
G28828 | CA | Allopathic & Osteopathic Physicians |
| Y | 207XP3100X |
Orthopaedic Surgery Specialization: Pediatric Orthopaedic Surgery |
G28828 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083108799 | James L Shively II | Counselor | 2151 Rush Blvd, Youngstown, OH 44507-1535 | 2018-06-15 |
| Street Address |
747 52ND ST |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-1809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942200928 | James Philip Riddel Jr. | Nurse Practitioner | 747 52nd St, Oakland, CA 94609-1809 | 2005-07-29 |
| 1235739905 | Maria Elena Alicia Valdivia Fortuna | Social Worker | 747 52nd St, Oakland, CA 94609-1809 | 2020-10-30 |
| 1295342707 | Jenny Chen | Dietitian, Registered | 747 52nd St, Oakland, CA 94609-1809 | 2020-09-29 |
| 1104433028 | Phuong T Nguyen-tran | Pharmacist | 747 52nd St, Oakland, CA 94609-1809 | 2020-09-24 |
| 1114538899 | Ji Yun Lee | Student in an Organized Health Care Education/Training Program | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-14 |
| 1780295857 | Luis Alonso Perez Jr. | Social Worker | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-12 |
| 1255941803 | Aleesia Renta-ramirez | Student in an Organized Health Care Education/Training Program | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-07 |
| 1831709773 | Carroll Taylor Brown IIi | Registered Nurse | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-05 |
| 1053921064 | Jessica Stankiewicz Lightcap | Registered Nurse | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-04 |
| 1184242307 | Cecilia Fairley | Genetic Counselor, MS | 747 52nd St, Oakland, CA 94609-1809 | 2020-07-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
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| Taxonomy Code | 207XP3100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Pediatric Orthopaedic Surgery |
| An orthopedic surgeon who has additional training and experience in diagnosing, treating and managing musculoskeletal problems in infants, children and adolescents. These may include limb and spine deformities (such as club foot, scoliosis); gait abnormalities (limping); bone and joint infections; broken bones. |
| Notes: Source: American Academy of Pediatrics, www.aap.org [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417188061 | Jason Edward Jagodzinski | Orthopaedic Surgery | 744 52nd St, Opc 1st Floor, Orthopaedics Clinic, Oakland, CA 94609-1810 | 2009-07-30 |
| 1760542203 | Nirav K Pandya | Orthopaedic Surgery | 747 52nd Street, Oakland, CA 94609-1809 | 2006-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154676559 | Michael Stuart Gurvey | Orthopaedic Surgery | 2390 Crombie Ct, Thousand Oaks, CA 91361-5322 | 2012-07-21 |
| 1447573779 | Darvin Charles Foo | Orthopaedic Surgery | 2425 Stockton Blvd Fl 7, Sacramento, CA 95817-2215 | 2010-03-01 |
| 1770793853 | Munir M Uwaydah | Orthopaedic Surgery | 211 S Maclay Ave, San Fernando, CA 91340-3603 | 2007-05-23 |
| 1689894057 | Lawrence Stephen Guinney | Orthopaedic Surgery | 4730 Hoen Ave, Santa Rosa, CA 95405-7868 | 2007-04-26 |
| 1275752602 | Richard Ros Ross Riddell | Orthopaedic Surgery | 20 N Vista De Catalina, Laguna Beach, CA 92651-6755 | 2007-04-24 |
| 1487700738 | James Gibson Gamble | Orthopaedic Surgery | 800 Welch Rd, Suite 212, Palo Alto, CA 94304-1607 | 2007-01-26 |
| 1801962360 | William Oppenheim | Orthopaedic Surgery | 10945 Le Conte Avenue, Rm 3355 Ubberoth Bldg Department of Orthopaedic Surgery, Los Angeles, CA 90095-6902 | 2006-11-27 |
| 1114005352 | Alpine Orthopaedic Medical Group Inc | Orthopaedic Surgery | 2488 N. California St, Stockton, CA 95204-5508 | 2006-11-02 |
| 1528179793 | Regents of The University of California | Orthopaedic Surgery | 100 Medical Plaza Suite 755, Los Angeles, CA 90095-0001 | 2006-08-31 |
| 1215948740 | Leah M Pike | Orthopaedic Surgery | 3742 Katella Ave, 303, Los Alamitos, CA 90720-3102 | 2006-08-10 |
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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.