Basic Information
Provider Information
NPI: 1275738775
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: SHAYNA
MiddleName: SAMPSON
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5 FIRST VILLAGE
Address2: PO BOX 2000
City: PINEHURST
State: NC
PostalCode: 28374
CountryCode: US
TelephoneNumber: 9102956831
FaxNumber: 9102950244
Practice Location
Address1: 5 FIRST VILLAGE DR
Address2:  
City: PINEHURST
State: NC
PostalCode: 28374
CountryCode: US
TelephoneNumber: 9102152533
FaxNumber: 9102950876
Other Information
ProviderEnumerationDate: 06/15/2007
LastUpdateDate: 09/06/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X204555NCN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207VG0400X201500092NCY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology

No ID Information.


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