NPIMap

Individual provider Active NPI

Shane Travis Kiser, PA-C

  • Physician Assistant
  • Olive Hill, KY
National Provider Identifier
1003286709
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2034 Issued in KY
Practice address
250 Kiser Cem Rd
Olive Hill, KY 41164-9809
Phone
(606) 780-5500
Fax
(606) 783-7281
NPI assigned
Oct 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2034 KY Primary

Addresses

Primary practice location

250 Kiser Cem Rd
Olive Hill, KY 41164-9809

Mailing address

250 Kiser Cem Rd
Olive Hill, KY 41164-9809
Phone (606) 780-5500

Other identifiers 2

IdentifierTypeStateIssuer
7100394790MedicaidKY
PA2034OtherKYKY MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151106000389 KY Practitioner - Physician Assistant 8022328897 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kings Daughters Medical Specialties IncGroup PAC ID 6103968029, 397 clinicians

Practice addresses (Care Compare)

100 Bellefonte Dr
Grayson, KY 41143-1820
Phone (606) 329-9335

2201 Lexington Ave
Ashland, KY 41101-2843
Phone (606) 408-4000

398 Diederich Blvd
Ashland, KY 41101-7008
Phone (606) 324-2055

Hospital & facility affiliations

  • King'S Daughters' Medical Center Hospital, Ashland, KY, CCN 180009
  • Kings Daughters Medical Center Ohio Hospital, Portsmouth, OH, CCN 360361

Merit-based Incentive Payment System (MIPS)

Final score
84.04 of 100Reported as group
Quality
60.55
Promoting interoperability
100
Improvement activities
40
Cost
78.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Daughters Medical Specialties Inc Medical CurrentSince Sep 12, 2022 Accepting new patients
Kings Daughters Medical Specialties Inc CurrentSince Sep 12, 2022 Accepting new patients
Ashland Hospital Corporation Physician Assistant Current Accepting new patients
St Claire Medical Center, Inc., Physician Assistant CurrentSince Aug 1, 2019 Accepting new patients
St Claire Medical Center, Inc CurrentSince Aug 1, 2019 Accepting new patients
Kings Daughters Medical Specialties Inc Physician Assistant Past Accepting new patients

Locations

10650 US Route 60
Ashland, KY 41102
Phone (606) 408-6301

336 29th St
Ste 101
Ashland, KY 41101
Phone (606) 324-4404

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

555 W Sun St
Morehead, KY 40351
Phone (606) 207-2931

222 Medical Cir
Morehead, KY 40351
Phone (606) 783-6455

245 Flemingsburg Rd
Morehead, KY 40351
Phone (606) 780-5500

Interoperability endpoints

  • Direct secure messaging: skiser24541@direct.kdhealth.us

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1003286709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 KISER CEM RD",
            "city": "OLIVE HILL",
            "state": "KY",
            "postal_code": "411649809",
            "telephone_number": "606-780-5500",
            "fax_number": "606-783-7281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 KISER CEM RD",
            "city": "OLIVE HILL",
            "state": "KY",
            "postal_code": "411649809",
            "telephone_number": "606-780-5500",
            "fax_number": "606-783-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISER",
        "first_name": "SHANE",
        "middle_name": "TRAVIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-07",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100394790",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY MEDICAL LICENSE",
            "identifier": "PA2034",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Hill, KY

Sources for this page

Verify at the official NPI Registry.