Shivam Ram Kedia, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

05102 Issued in KY

Practice address

7766 Ewing Blvd
Florence, KY 41042-7537

Phone

(859) 371-1153

Fax

(859) 647-5113

NPI assigned

Apr 16, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Lake Erie College of Osteopathic Medicine, Bradenton, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health of Kentucky Home health agency, Crestview Hills, KY, CCN 187179
• St Elizabeth Home Care Home health agency, Florence, KY, CCN 187075
• St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035
• St Elizabeth Florence Hospital, Florence, KY, CCN 180045

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: skedia364134@direct-prd.stelizabeth.com

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.

• Summit Medical Group, Inc

  • Family Medicine Physician
  • Erlanger, KY
  • NPI 1750343216
  Medicare reassignment Care Compare group NPD
• Summit Medical Group, Inc.

  • Foot & Ankle Surgery Podiatrist
  • Crestview Hills, KY
  • NPI 1043188378
  NPD
• Summit Medical Group, Inc.

  • Urgent Care Clinic/Center
  • Highland Heights, KY
  • NPI 1881026169

  Family Medicine

  NPD

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

• Amedisys SP-Oh, L.L.C.

  • Home Health Agency
  • Crestview Hills, KY
  • NPI 1215940093
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Florence, KY
  • NPI 1154365062
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Edgewood, KY
  • NPI 1467492421
  Care Compare affiliation
• St. Elizabeth Home Care Services, LLC

  • Home Health Agency
  • Florence, KY
  • NPI 1316136534
  Care Compare affiliation

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1013404938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-371-1153",
            "fax_number": "859-647-5113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7766 EWING BLVD",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410427537",
            "telephone_number": "859-371-1153",
            "fax_number": "859-647-5113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEDIA",
        "first_name": "SHIVAM",
        "middle_name": "RAM",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-16",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "TP272",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "05102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Kappes, RPH
• Timothy J. Kappes, PA-C
• Arik Kashner
• Kathryn Blair Plymale LLC
• Feryal Khan Katsikas, M.A./ LPCC
• Ellen Brooke Kelly, OD
• Virginia Kelly
• Kathryn Miller Kelsay, APRN
• Adam Kelsey, LMT
• Kristin Dietz Kennedy, ARNP

• Family Medicine Physician in Florence, KY
• Providers in Florence, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.