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Deactivated NPI 1205138591 Deactivated / Inactive NPI Male Practitioner

Edwin Andrew Shivers , PA

Physician Assistant • Rockwall, TX

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Edwin Shivers has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 19, 2010
NPI Deactivation Date April 23, 2026
Total Practice Duration ~16 Years of Practice (2010 – 2026)

Professional Overview & Biography Verified Profile Summary

Edwin Shivers, PA was a registered Physician Assistant practicing in Rockwall, TX. Throughout an active medical career spanning 16 years, Edwin Shivers provided care at the practice location at 3142 HORIZON RD STE 100 until profile deactivation on 2026-04-23.

Historical Medicare Part B clinical services included partial removal of middle spine bone with release of spinal cord and/or nerves, fusion of spine in lower back, insertion of cage or mesh device to spine bone and disc space during spine fusion. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

3142 Horizon Rd Ste 100

Rockwall, TX 750327809

Telephone 9727729600
Fax 9727729601
Associated Practice Facility / Clinic
🏢 Texas Health Back Care Facility NPI 1811366982

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Rockwall, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 12.0 Yrs
State Avg: 13.9 Yrs
Regional Practice Density
40 Specialists

Practicing in Rockwall, TX (11140 Statewide)

Telehealth Adoption Rate
17.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
96.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves
12 11 $3355.00 $114.46

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License TX PA06939

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Dr. Anton Zaryanov , DO

Orthopaedic Surgery - Orthopaedic Surgery of the Spine

NPI 1013285758

Doctor of Osteopathic Medicine (D.O.)

Markus Bader , PA

Physician Assistant - Surgical

NPI 1174730816

Physician Assistant

Stephanie Hays , PA-C

Physician Assistant

NPI 1477962991

Physician Assistant (Certified)

Dr. Joseph Platon , DO

Physical Medicine & Rehabilitation

NPI 1578856571

Doctor of Osteopathic Medicine (D.O.)

Dr. Alexa Royston , DO

Physical Medicine & Rehabilitation

NPI 1649625450

Doctor of Osteopathic Medicine (D.O.)

Dr. Richard Mcpherson , DO

Pain Medicine - Interventional Pain Medicine

NPI 1770691123

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated April 23, 2026

Record deactivated on April 23, 2026

NPI Profile Active May 25, 2016

NPI status registered as active in NPPES database

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Updated Practice Location May 25, 2016

Registered at 3142 HORIZON RD STE 100, ROCKWALL, TX 750327809 (Tel: 9727729600)

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Updated Business Mailing Address May 25, 2016

Registered at 3142 HORIZON RD STE 100, ROCKWALL, TX 750327809 (Tel: 9727729600)

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Provider Name / Credentials Updated May 25, 2016

Recorded as EDWIN SHIVERS, P.A.

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 25, 2016

Physician Assistant (License #PA06939 in TX)

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Initial NPI Registration & Enumeration November 19, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1205138591
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 19, 2010
Last Update: May 25, 2016
Deactivation Date: April 23, 2026

Mailing Address

3142 Horizon Rd Ste 100

Rockwall, TX 750327809

Phone: 9727729600

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.