Carol Shackleton, M.D., P.C.
LBN: Carol Shackleton, M.D., P.C.
Carol Shackleton, M.D., P.C. is an health care organization with primary practice located at 918 20Th Street , Gothenburg NE 69138-1237. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty.
Carol Shackleton, M.D., P.C. can be contacted via phone (308) 537-7131, or through Shackleton, Carol via phone (308) 537-7131.
Contact Information
Primary practice address
918 20Th Street
Gothenburg NE 69138-1237
Phone: (308) 537-7131
Fax: (308) 537-7310
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 16620 | Nebraska |
Profile Details
| NPI number | 1194803619 |
|---|---|
| LBN Legal business name | Carol Shackleton, M.D., P.C. |
| DBA Doing business as | |
| Authorized official | Shackleton, Carol Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 1st, 2006 |
| Last updated | Feb 9th, 2012 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194803619 | NPPES |
| Nebraska | Other | 11595205 | CAQH |
| Nebraska | Other | 280121 | CAQH |
| Nebraska | Other | 03042 | CAQH |
| Nebraska | Other | 099905 | CAQH |
| Nebraska | Other | 6366 | CAQH |
| Nebraska | MEDICAID | 100253852-00 | CAQH |
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