Active NPI
Thomas M Shields, MD
- Surgery Physician
- Manhattan, KS
National Provider Identifier
1013905041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 04-16954
- Practice address
- 1133 College Ave
BLDG E-220
Manhattan, KS 66502-2777 - Phone
- (785) 539-5341
- Fax
- (785) 539-1238
- NPI assigned
- Oct 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 0416954 | KS | |
| Surgery Physician | 208600000X | 04-16954 | KS | Primary |
Addresses
Primary practice location
1133 College Ave
BLDG E-220
Manhattan, KS 66502-2777
Mailing address
1133 College Ave
BLDG E-220
Manhattan, KS 66502-2777
Phone (785) 539-5341
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100293760A | Medicaid | KS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-16954 | KS | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309132800000",
"number": "1013905041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1133 COLLEGE AVE",
"address_2": "BLDG E-220",
"city": "MANHATTAN",
"state": "KS",
"postal_code": "665022777",
"telephone_number": "785-539-5341",
"fax_number": "785-539-1238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1133 COLLEGE AVE",
"address_2": "BLDG E-220",
"city": "MANHATTAN",
"state": "KS",
"postal_code": "665022777",
"telephone_number": "785-539-5341",
"fax_number": "785-539-1238"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIELDS",
"first_name": "THOMAS",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-13",
"last_updated": "2011-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "KS",
"license": "0416954",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "KS",
"license": "04-16954",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100293760A",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Manhattan, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.