NPIMap

Organization Active NPI

Michael W. McShan, M.D., P.a.

  • Family Medicine Physician
  • Kilgore, TX
National Provider Identifier
1033481106
Registry record updated Feb 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E4519 Issued in TX
Legal business name
MICHAEL W. MCSHAN, M.D., P.A.
Practice address
1711 S Henderson Blvd
Suite 300
Kilgore, TX 75662-3563
Phone
(903) 983-1578
NPI assigned
Feb 3, 2012
Last updated
Feb 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2012

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

Authorized official

Name
Dr. Michael W McShan, M.D.NPI 1912082249
Title
President
Phone
(903) 983-1578

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E4519 TX Primary

Addresses

Primary practice location

1711 S Henderson Blvd
Suite 300
Kilgore, TX 75662-3563

Mailing address

1711 S Henderson Blvd
Suite 300
Kilgore, TX 75662-3563
Phone (903) 983-1578

Other identifiers 1

IdentifierTypeStateIssuer
130926203MedicaidTX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328227200000",
    "number": "1033481106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 S HENDERSON BLVD",
            "address_2": "SUITE 300",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756623563",
            "telephone_number": "903-983-1578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 S HENDERSON BLVD",
            "address_2": "SUITE 300",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756623563",
            "telephone_number": "903-983-1578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL W. MCSHAN, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-03",
        "last_updated": "2012-02-03",
        "status": "A",
        "authorized_official_last_name": "MCSHAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-983-1578",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "E4519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130926203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kilgore, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; 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.