VICTOR A. SHADA, D.O., P.C.
NPI 1407037211
Family Medicine in Crossville, TN
About Victor A. Shada, D.o., P.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
VICTOR A. SHADA, D.O., P.C. (NPI 1407037211) is a healthcare organization registered as a family medicine in Crossville, Tennessee and active in the NPI registry since November 2007. The organization lists Victor Anthony Shada, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Victor A. Shada, D.o., P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Victor A. Shada, D.O., P.C., which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
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 Victor A. Shada, D.O., P.C.'s NPI number?
The NPI number for Victor A. Shada, D.O., P.C. is 1407037211. It was assigned to this organization in the NPPES registry on November 20, 2007.
Where is Victor A. Shada, D.O., P.C. located?
Victor A. Shada, D.O., P.C. is located at 396 S Main St, Crossville, TN 38555. The listed phone number is (931) 484-4560.
What is Victor A. Shada, D.O., P.C.'s specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Victor A. Shada, D.O., P.C. enrolled in Medicare?
Yes. Victor A. Shada, D.O., P.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Victor A. Shada, D.O., P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Victor A. Shada, D.O., P.C., in Family Practice 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, 2 practice 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 Victor A. Shada, D.O., P.C. was last updated on July 9, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Victor A. Shada, D.o., P.c. · NPI 1407037211
Family Medicine organization in Crossville, Tennessee. Organization record, active in the CMS NPPES registry since November 20, 2007.
## Identity
- **NPI:** 1407037211 (Entity type: Organization)
- **Enumerated:** November 20, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Victor Shada, OWNER
## Practice location
- **Address:** 396 S MAIN ST, Crossville, TN 38555-5092
- **Phone:** (931) 484-4560 · **Fax:** (931) 484-1480
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), Nurse Practitioner (1); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 9, 2010
- **Other identifiers:** Medicare UPIN G94880 (TN); Medicare PIN 3306875 (TN); Medicaid 3306875 (TN)
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Source: [NPI Profile](https://npiprofile.com/npi/1407037211) · Data from the CMS NPPES public registry.