RICHARD D SHACK (NPI# 1942313572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942313572 |
| Entity Type | Individual |
| Full Name | RICHARD D SHACK |
| Credential | MD |
| Practice Address |
3400 C Old Milton Parkway Suite 270 Alpharetta GA 30005 |
| Practice Telephone | 7704421911 |
| Practice Fax Number | 7706638905 |
| Mailing Telephone | 7704421911 |
| Mailing Fax Number | 7706638905 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2015-06-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 061856 | GA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 22858 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | BCBS | 051502030 | 01 |
| AL | 009960760 | 05 |
| Street Address |
3400 C OLD MILTON PARKWAY SUITE 270 |
| City | ALPHARETTA |
| State | GA |
| Zip Code | 30005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699771303 | Gayle L. Mason | Internal Medicine | 3400 C Old Milton Parkway, Ste 425, Alpharetta, GA 30005 | 2005-06-27 |
| 1841555893 | Arielle Handy Sullivan-harris | Family Medicine | 3400 C Old Milton Parkway, Suite 270, Alpharetta, GA 30005 | 2012-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922615483 | Amarrah Shatia Guyton | Behavior Technician | 6505 Shiloh Point Road, Alpharetta, GA 30005 | 2020-09-29 |
| 1396351771 | Stephanie Hightower | Behavior Technician | 6505 Shiloh Pt Rd, Alpharetta, GA 30005 | 2020-09-21 |
| 1689130874 | Optima Eye Care LLC | Optometrist | 6365 Halcyon Way, Suite 935, Alpharetta, GA 30005 | 2019-02-13 |
| 1275006652 | Ariel Kaitlyn Petrakovich | Behavioral Analyst | 6505 Shiloh Road, Suite 100, Alpharetta, GA 30005 | 2019-01-08 |
| 1003306515 | Brightview Pharmacy, LLC | Pharmacy | 3333 Old Milton Pkwy Ste 130, Alpharetta, GA 30005 | 2018-05-10 |
| 1316452600 | Kara Marie Arps | Physical Therapist | 855 Yearling Chase, Alpharetta, GA 30005 | 2017-12-08 |
| 1417468307 | Paige Biringer | Physical Therapist | 6495 Shiloh Rd Ste 100, Alpharetta, GA 30005 | 2017-10-18 |
| 1528587169 | Laura Kinney Pearce | Speech-Language Pathologist | 6505 Shiloh Rd #100, Alpharetta, GA 30005 | 2017-09-14 |
| 1629526678 | Samantha Menton | Chiropractor | 11875 Jones Bridge Road, Suite A, Alpharetta, GA 30005 | 2016-09-20 |
| 1427424183 | Trek Medical, LLC | Clinic/Center | 5895 Windward Parkway, Suite 150, Alpharetta, GA 30005 | 2015-08-18 |
| Find all providers in zip 30005 | ||||
| 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 |
|---|---|---|---|---|
| 1851909535 | Newly Sought After International LLC | Family Medicine | 11815 Northfall Ln Ste 1001, Alpharetta, GA 30009-7973 | 2020-07-17 |
| 1982244463 | Youthful Md LLC | Family Medicine | 10595 Old Alabama Rd Con, # 9a, Alpharetta, GA 30022 | 2020-01-13 |
| 1457901209 | Carehere LLC | Family Medicine | Carehere Clinic- Jackson Healthcare, 2655 Northwinds Pkwy, Alpharetta, GA 30009 | 2019-09-13 |
| 1386054336 | Navdeep Mangat | Family Medicine | 450 Walden Glen Ln, Alpharetta, GA 30004-1436 | 2014-04-30 |
| 1447699152 | Jay Frederick Morgan | Family Medicine | 501 S Main St Ste 202, Alpharetta, GA 30009-1975 | 2013-06-17 |
| 1891041125 | Pooja Agarwal | Family Medicine | 3400 Old Milton Pkwy Ste 270, Alpharetta, GA 30005-3707 | 2012-07-24 |
| 1598064636 | Charles Phillips | Family Medicine | 6045 Carlisle Ln, 6045 Carlisle Ln, Alpharetta, GA 30022-6281 | 2011-03-15 |
| 1134429566 | Hoyland Harris Ricks | Family Medicine | 11675 Great Oaks Way, Alpharetta, GA 30022-2421 | 2010-11-02 |
| 1942515531 | Amena Samar | Family Medicine | 120 Sunvalley Dr, Alpharetta, GA 30004-4383 | 2010-08-09 |
| 1275844847 | Stephen Matthew Cox | Family Medicine | 2450 Old Milton Pkwy Ste 201, Alpharetta, GA 30009-2108 | 2010-06-29 |
| Find all providers in ALPHARETTA | ||||
| City | ALPHARETTA |
| Zip Code | 30005 |
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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.