Provider Demographics
NPI:1144331778
Name:SHAPCOTT, THOMAS A (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:SHAPCOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 N AUGUSTA ST
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-2402
Mailing Address - Country:US
Mailing Address - Phone:540-886-1300
Mailing Address - Fax:540-886-2545
Practice Address - Street 1:1429 N AUGUSTA ST
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-2402
Practice Address - Country:US
Practice Address - Phone:540-886-1300
Practice Address - Fax:540-886-2545
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101036790207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA386115OtherANTHEM BCBS
VA3317995006OtherCIGNA NUMBER
VA158491OtherSOUTHERN HEALTH
VA8100653OtherMAMSI NUMBER
VA005645743Medicaid
VA190000688Medicare PIN
VA386115OtherANTHEM BCBS