Individual provider Active NPI

George Theodore Shybut, M.D.

  • Orthopaedic Surgery Physician
  • Cincinnati, OH
National Provider Identifier
1023013471
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
350559319S Issued in OH
Practice address
4440 Glen Este Withamsville Rd
Suite 500
Cincinnati, OH 45245-1318
Phone
(513) 753-7488
Fax
(513) 753-7879
NPI assigned
Jun 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 350559319S OH Primary
Orthopaedic Surgery Physician 207X00000X 31910 KY
Orthopaedic Surgery Physician 207X00000X 036054951 IL
Orthopaedic Surgery Physician 207X00000X 01041143A IN

Addresses

Primary practice location

4440 Glen Este Withamsville Rd
Suite 500
Cincinnati, OH 45245-1318

Mailing address

4440 Glen Este Withamsville Rd
Suite 500
Cincinnati, OH 45245-1318
Phone (513) 753-7488

Other identifiers 5

IdentifierTypeStateIssuer
3284491OtherOHCIGNA
P00321556OtherOHMEDICARE RAILROAD
000000382638OtherOHANTHEM
0785011MedicaidOH
0903535OtherOHUNITED HEALTHCARE

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

LicenseStateTypeSpecialty
036054951ILMDOrthopaedic Surgery Physician
01041143AINMDOrthopaedic Surgery Physician
31910KYMDOrthopaedic Surgery Physician
350559319SOHMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Consultants of Cincinnati, Inc. Orthopaedic Surgery Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1023013471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 GLEN ESTE WITHAMSVILLE RD",
            "address_2": "SUITE 500",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452451318",
            "telephone_number": "513-753-7488",
            "fax_number": "513-753-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 GLEN ESTE WITHAMSVILLE RD",
            "address_2": "SUITE 500",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452451318",
            "telephone_number": "513-753-7488",
            "fax_number": "513-753-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHYBUT",
        "first_name": "GEORGE",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "350559319S",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "KY",
            "license": "31910",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036054951",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "01041143A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3284491",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00321556",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000382638",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0785011",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0903535",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.