1750366829 NPI number — MRS. CHRISTINA N. SHINAVER M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750366829 NPI number — MRS. CHRISTINA N. SHINAVER M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

SHINAVER

Provider First Name:

CHRISTINA

Provider Middle Name:

N.

Provider Name Prefix Text:

MRS.

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1750366829

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

01/31/2022

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

8900 N KENDALL DR

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

MIAMI

Provider Business Mailing Address State Name:

FL

Provider Business Mailing Address Postal Code:

33176-2118

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

786-596-5917

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

5901 TECHNOLOGY CENTER DRIVE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

INDIANAPOLIS

Provider Business Practice Location Address State Name:

IN

Provider Business Practice Location Address Postal Code:

46278-6013

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

317-328-5050

Provider Business Practice Location Address Fax Number:

317-715-9965

Provider Enumeration Date:

12/13/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2085N0700X , with the licence number:  ME154026 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 01044773A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: ME154026 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 000000368993 . This is a "ANTHEM-351158723" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
• Identifier: 000000492367 . This is a "ANTHEM 203778927" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
• Identifier: P00251843 . This is a "RR MEDICARE-351158723" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
• Identifier: 062496 . This is a "SIHO-351158723" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
• Identifier: 200124720 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: Q0429607 . This is a "CMOSHO351158723&352047427" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
• Identifier: 108063 . This is a "HEALTH ALLIANCE-351158723" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
• Identifier: 112788700 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".