1. Home
  2. Directory
  3. Alabama
  4. Dothan
  5. Clinic Center
  6. NPI Profile

SHA DIABETES CENTER LLC
NPI 1063293603
Clinic/Center in Dothan, AL

Active since October 10, 2023
172 LUDS WAY, DOTHAN, AL 36304(334) 475-0646(334) 888-8445 Get Directions Write a Review

NPPES record last updated: January 12, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Sha Diabetes Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHA DIABETES CENTER LLC (NPI 1063293603) is a healthcare organization registered as a clinic/center in Dothan, Alabama and active in the NPI registry since October 2023. The organization lists Tai Bolaji, Dr./ceo, as its authorized official.

NPPES Registry Identity

NPI1063293603
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameSHA DIABETES CENTER LLC
Location Address172 LUDS WAYDothan, AL 36304-8803
Mailing Address172 Luds Way,, P. O. Box 8803Dothan, AL 36304-8803 · (334) 778-7090
Phone(334) 475-0646
Fax(334) 888-8445
Organization SubpartNo
Authorized OfficialTai BolajiDr./ceo · (334) 778-7090
Enumeration DateOctober 10, 2023
Last NPPES UpdateJanuary 12, 2024
NPPES CertifiedJanuary 12, 2024
✔ NPI 1063293603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
172 LUDS WAY, Dothan, AL 36304
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sha Diabetes Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Sha Diabetes Center LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Toyin Bolaji
Nurse Practitioner
NPI 1699752808
172 LUDS WAY
Dothan, AL 36303
(334) 778-7090
✔ PECOS✔ Accepts MedicareSame address
Brandy Long, NP
Nurse Practitioner
NPI 1497255160
1736 E MAIN ST
Dothan, AL 36301
(334) 712-9999
✔ PECOS✔ Accepts Medicare5.7 mi
Elisha Collins, M.D.
General Surgery
NPI 1093000861
101 E BRUNSON ST STE 300
Enterprise, AL 36330
(334) 393-3212
✔ PECOS✔ Accepts Medicare24 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sha Diabetes Center LLC's NPI number?

The NPI number for Sha Diabetes Center LLC is 1063293603. It was assigned to this organization in the NPPES registry on October 10, 2023.

Where is Sha Diabetes Center LLC located?

Sha Diabetes Center LLC is located at 172 Luds Way, Dothan, AL 36304. The listed phone number is (334) 475-0646.

What is Sha Diabetes Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Sha Diabetes Center LLC enrolled in Medicare?

Yes. Sha Diabetes Center LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Sha Diabetes Center LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Sha Diabetes Center LLC, in General Surgery and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Sha Diabetes Center LLC was last updated on January 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.