SHANE HIGGINBOTHAM MD PA (NPI# 1104106426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104106426 |
| Entity Type | Organization |
| Organization Name | SHANE HIGGINBOTHAM MD PA |
| Other Organization Name | HIGGINBOTHAM FAMILY CLINIC |
| Practice Address |
1002 Schneider Dr Malvern AR 72104-4816 |
| Practice Telephone | 5013327981 |
| Practice Fax Number | 5013379964 |
| Mailing Telephone | 5013327981 |
| Mailing Fax Number | 5013379964 |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2012-03-22 |
| Authorized Official Name | JUDY HOWARD (OFFICE MANAGER) |
| Authorized Official Telephone | 5013327981 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA251 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207Q00000X | Family Medicine | E0968 | AR | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Higginbotham Family Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033129713 | Shane Higginbotham Md Pa | Physician Assistant | 1002 Schneider Dr, Suite 104, Malvern, AR 72104-4816 | 2006-08-08 |
| Street Address |
1002 SCHNEIDER DR |
| City | MALVERN |
| State | AR |
| Zip Code | 72104-4816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720054125 | Altimus Ray Bollen | Internal Medicine | 1002 Schneider Dr, Suite 104, Malvern, AR 72104-4816 | 2006-02-24 |
| 1629536255 | Amanda R Masters-stephens | Nurse Practitioner | 1002 Schneider Dr, Malvern, AR 72104-4816 | 2019-03-02 |
| 1013460849 | Presidential Emergency Physicians, LLC | Nurse Practitioner | 1002 Schneider Dr, Malvern, AR 72104-4816 | 2016-07-28 |
| 1881002756 | Heather Grigsby | Nurse Practitioner | 1002 Schneider Dr, Malvern, AR 72104-4816 | 2014-07-23 |
| 1053692137 | Hot Spring County Medical Services | Surgery | 1002 Schneider Dr, Suite 102, Malvern, AR 72104-4816 | 2011-09-02 |
| 1811168537 | Courtney C Bickerstaff | Nurse Practitioner | 1002 Schneider Dr, Suite 104, Malvern, AR 72104-4816 | 2008-03-20 |
| 1033129713 | Shane Higginbotham Md Pa | Physician Assistant | 1002 Schneider Dr, Suite 104, Malvern, AR 72104-4816 | 2006-08-08 |
| 1730104340 | Edward T Costello | Physician Assistant | 1002 Schneider Dr, Suite 104, Malvern, AR 72104-4816 | 2006-07-13 |
| 1881660058 | Bruce Allen White | Family Medicine | 1002 Schneider Dr, Suite 104, Malvern, AR 72104-4816 | 2006-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659907707 | Terrence Randell Mitchell | Prosthetist | 991 Mount Willow Rd., Malvern, AR 72104 | 2020-03-20 |
| 1356837959 | American Oncology Partners, P.a. | Internal Medicine | 1001 Schneider Dr Ste 105, Malvern, AR 72104 | 2018-07-06 |
| 1114262839 | Charloda Nolen | Case Manager/Care Coordinator | 1710 E Page, Malvern, AR 72104 | 2012-12-06 |
| 1427349257 | Malvern Physical Therapy and Wellness | Physical Therapist | 1601 Hwy 270 W, Suite 104, Malvern, AR 72104 | 2011-04-27 |
| 1194037069 | Alternative Opportunities | Community/Behavioral Health | 1519 East Page Avenue, Malvern, AR 72104 | 2010-07-08 |
| 1285878991 | Pro-active Rehab Inc. | Physical Therapist | 720 Walco Rd, Suite 240, Malvern, AR 72104 | 2009-04-24 |
| 1932380599 | Vallerie Ahart | Licensed Practical Nurse | 1022 East Page, Malvern, AR 72104 | 2007-11-23 |
| 1104013598 | Vivian Brown | Home Health Aide | 913 Magnolia, Malvern, AR 72104 | 2007-09-28 |
| 1467665919 | Annette Jean Bowersox | Registered Nurse | 1399 Jenny Road, Malvern, AK 72104 | 2007-05-08 |
| 1730305798 | Jacqueline Kilgore LLC | Skilled Nursing Facility | 912 Section Line St, Malvern, AR 72104 | 2007-04-18 |
| Find all providers in zip 72104 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831110758 | Larry Bruce Brashears | Family Medicine | 1517 S Main St, Malvern, AR 72104 | 2006-07-23 |
| 1619992377 | Michael S Higginbotham | Family Medicine | 1002 Schneider Dr Ste 104, Malvern, AR 72104-4823 | 2006-07-13 |
| 1912934837 | Joseph B Straton | Family Medicine | 2476 Swedesford Rd Ste 150, Malvern, PA 19355-1456 | 2006-06-27 |
| 1588603641 | Stephanie B Bennett | Family Medicine | 229 Line Rd, Malvern, PA 19355-3320 | 2006-06-05 |
| 1861450942 | Shawn Purifoy | Family Medicine | 850 Henry St, Malvern, AR 72104-2712 | 2006-05-01 |
| 1922062249 | Maria H. Dahl | Family Medicine | 1340 Shadow Oak Drive, Malvern, PA 19355 | 2006-04-13 |
| 1356319511 | Arkansas Health Group | Family Medicine | 1234 S Main St, Malvern, AR 72104-5226 | 2006-03-14 |
| 1336128289 | Steven Richard Stasiak | Family Medicine | 635 Locust Street, Malvern, OH 44644 | 2006-01-10 |
| 1003815044 | A Hatton Blair | Family Medicine | 2140 Howell Rd, Malvern, PA 19355-9518 | 2005-07-20 |
| 1811995152 | Harris Robert Hayman | Family Medicine | 9 Oak Hill Cir, Malvern, PA 19355 | 2005-07-11 |
| Find all providers in MALVERN | ||||
Please comment or provide details below to improve the information on SHANE HIGGINBOTHAM MD PA.
| 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.