Active NPI
Sheelah C Changho, MD
- Anatomic Pathology Physician
- Oro Valley, AZ
National Provider Identifier
1063736601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology Physician
- License
- 2008015503
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200679940A | Medicaid | KS | |
| 44273019 | Other | BCBS-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
| License | State | Type | Specialty |
|---|---|---|---|
| 54951 | AZ | MD | Anatomic Pathology Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Certified Registered Nurse Anesthetist
- Leawood, KS
- NPI 1366559130
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.