Individual provider Active NPI

Sheelah C Changho, MD

  • Anatomic Pathology Physician
  • Oro Valley, AZ
National Provider Identifier
1063736601
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
2008015503 Issued in MO
Practice address
1910 E Innovation Park Dr
Oro Valley, AZ 85755-1962
Phone
(520) 247-5841
NPI assigned
Mar 25, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 54951 AZ
Anatomic Pathology Physician 207ZP0101X 2008015503 MO Primary

Addresses

Primary practice location

1910 E Innovation Park Dr
Oro Valley, AZ 85755-1962

Mailing address

2873 E Indian Wells PL
Chandler, AZ 85249-4917
Phone (913) 219-3324

Other identifiers 2

IdentifierTypeStateIssuer
200679940AMedicaidKS
44273019OtherBCBS-KC

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
54951AZMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Anesthesia, LLC 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": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1063736601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2873 E INDIAN WELLS PL",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852494917",
            "telephone_number": "913-219-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 E INNOVATION PARK DR",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857551962",
            "telephone_number": "520-247-5841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANGHO",
        "first_name": "SHEELAH",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-25",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "AZ",
            "license": "54951",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "MO",
            "license": "2008015503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200679940A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-KC",
            "identifier": "44273019",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oro Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.