Shauna Kay Sidhom, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71002333A Issued in IN

Practice address

4026 Madison Ave
Indianapolis, IN 46227

Phone

(317) 788-0396

Fax

(317) 780-0860

NPI assigned

Dec 10, 2007

Last updated

Apr 9, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Shauna Kay Hollinger Former name

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cinqcare at Home PCGroup PAC ID 1456769330, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shauna.sidhom.1@32399.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cinqcare at Home PC

  dba Grace at Home

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1235736067

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Affinity Care of Indiana LLC

  • Community Based Hospice Care Agency
  • Indianapolis, IN
  • NPI 1982360350

  Family

  Medicare reassignment NPD
• Care Medical Practice PLLC

  • Family Medicine Physician
  • Buffalo, NY
  • NPI 1811658883

  IN, Nurse Practitioner

  Medicare reassignment NPD
• Grace Divine, LLC

  dba Grace At Home, Primary Care House Calls

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1548596372
  Medicare reassignment
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1104009430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SOUTH MERIDIAN STREET",
            "address_2": "SUITE 400",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4026 MADISON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46227",
            "telephone_number": "317-788-0396",
            "fax_number": "317-780-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDHOM",
        "first_name": "SHAUNA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-10",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71002333A",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71002333A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAUNA",
            "last_name": "HOLLINGER",
            "middle_name": "KAY",
            "prefix": "MISS",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Fahad Shoaib Siddiqui, DO
• Fareesa Siddiqui, OD
• Khurram S Siddiqui, MD
• Mohammad Ahsan Siddiqui
• Daniel Alfred Sidhom, DO
• Angad Sidhu
• Parampreet Sidhu, PA-C
• Tracy M Sidibe
• Zaharaou Sadou Sidikou
• John E Sidle, MD

• Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.