Kenneth Shum, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2211 Issued in NE

Practice address

715 N Saint Joseph Ave
Hastings, NE 68901-4451

Phone

(402) 463-4521

Fax

(402) 460-5412

NPI assigned

Feb 18, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

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

Emergency Medicine

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

The Mary Lanning Memorial Hospital AssociationGroup PAC ID 4587575550, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mary Lanning Healthcare Hospital, Hastings, NE, CCN 280032
• CHI Health St. Elizabeth Hospital, Lincoln, NE, CCN 280020

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kshum156134@direct.nebraskamed.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.

• Alegent Creighton Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907
  Medicare reassignment Care Compare group NPD
• The Mary Lanning Memorial Hospital Association

  • Family Medicine Physician
  • Hastings, NE
  • NPI 1356656417

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• Grand Island Regional Medical Center

  • Emergency Medicine Physician
  • Grand Island, NE
  • NPI 1225658495
  Medicare reassignment NPD
• The Mary Lanning Memorial Hospital Association

  • Anatomic Pathology & Clinical Pathology Physician
  • Hastings, NE
  • NPI 1760530216
  NPD
• Grand Island Regional Medical Center

  • General Acute Care Hospital
  • Grand Island, NE
  • NPI 1558910604
  NPD (past)

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

• Saint Elizabeth Regional Medical Center

  • General Acute Care Hospital
  • Lincoln, NE
  • NPI 1336155738
  Care Compare affiliation
• The Mary Lanning Memorial Hospital Association

  • Clinical Medical Laboratory
  • Hastings, NE
  • NPI 1205442258

  Hospital

  Care Compare affiliation
• The Mary Lanning Memorial Hospital Association

  • Rural Acute Care Hospital
  • Hastings, NE
  • NPI 1831203488
  Care Compare affiliation

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

{
    "created_epoch": "1487376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1013456474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 N SAINT JOSEPH AVE",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689014451",
            "telephone_number": "402-463-4521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N SAINT JOSEPH AVE",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689014451",
            "telephone_number": "402-463-4521",
            "fax_number": "402-460-5412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8401 Market St",
            "address_purpose": "LOCATION",
            "city": "Boardman",
            "state": "OH",
            "postal_code": "445126725",
            "country_code": "US",
            "telephone_number": "330-729-8757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUM",
        "first_name": "KENNETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-18",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "2211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Shore
• Mia Short
• Jennifer Shriver
• Lilian Shuler
• Brandee Shulz
• Sarah Yvonne Shurigar-Meyer, LICSW
• David Allen Sickels
• Maryann Silva
• Joan E Simmons, LMHP
• Brett Alan Simonsen, PT, DPT, CSCS

• Emergency Medicine Physician in Hastings, NE
• Providers in Hastings, NE by specialty
• Emergency Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; 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.